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. 2021 Jul;35(4):404-414.
doi: 10.1111/ppe.12668. Epub 2020 Mar 19.

Interpregnancy interval and hypertensive disorders of pregnancy: A population-based cohort study

Amanuel T Gebremedhin  1 , Annette K Regan  1   2 , Stephen Ball  3 , Ana P Betrán  4 , Damien Foo  1 , Mika Gissler  5   6 , Siri E Håberg  7 , Eva Malacova  1   8 , Michael Luke Marinovich  1 , Gavin Pereira  1   7   9
Affiliations

Interpregnancy interval and hypertensive disorders of pregnancy: A population-based cohort study

Amanuel T Gebremedhin et al. Paediatr Perinat Epidemiol. 2021 Jul.

Abstract

Background: Despite extensive research on risk factors and mechanisms, the extent to which interpregnancy interval (IPI) affects hypertensive disorders of pregnancy in high-income countries remains unclear.

Objectives: To examine the association between IPI and hypertensive disorders of pregnancy in a high-income country setting using both within-mother and between-mother comparisons.

Methods: A retrospective population-based cohort study was conducted among 103 909 women who delivered three or more consecutive singleton births (n = 358 046) between 1980 and 2015 in Western Australia. We used conditional Poisson regression with robust variance, matching intervals of the same mother and adjusted for factors that vary within-mother across pregnancies, to investigate the association between IPI categories (reference 18-23 months), and the risk of hypertensive disorders of pregnancy. For comparison with previous studies, we also applied unmatched Poisson regression (between-mother analysis).

Results: The incidence of preeclampsia and gestational hypertension during the study period was 4%, and 2%, respectively. For the between-mother comparison, mothers with intervals of 6-11 months had lower risk of preeclampsia with adjusted relative risk (RR) 0.92 (95% confidence interval [CI] 0.85, 0.98) compared to reference category of 18-23 months. With the within-mother matched design, we estimated a larger effect of long IPI on risk of preeclampsia (RR 1.29, 95% CI 1.18, 1.42 for 60-119 months; and RR 1.30, 95% CI 1.10, 1.53 for intervals ≥120 months) compared to 18-23 months. Short IPIs were not associated with hypertensive disorders of pregnancy.

Conclusions: In our cohort, longer IPIs were associated with increased risk of preeclampsia. However, there was insufficient evidence to suggest that short IPIs (<6 months) increase the risks of hypertensive disorders of pregnancy.

Keywords: birth spacing; hypertensive disorders of pregnancy; interpregnancy interval; pregnancy complications; within-mother.

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References

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