Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-13T01:26:33.728Z Has data issue: false hasContentIssue false

Inter-pregnancy interval and later pediatric cardiovascular health of the offspring – a population-based cohort study

Published online by Cambridge University Press:  02 December 2020

Majdi Imterat*
Affiliation:
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Tamar Wainstock
Affiliation:
Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Eyal Sheiner
Affiliation:
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Gali Pariente
Affiliation:
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
*
Address for correspondence: Majdi Imterat, MD, Department of Obstetrics and Gynecology, Soroka University Medical Center, 151 Izak Rager Ave., Beer-Sheva84101, Israel. Email: magdi_333@hotmail.com

Abstract

Recent evidence suggests that a long inter-pregnancy interval (IPI: time interval between live birth and estimated time of conception of subsequent pregnancy) poses a risk for adverse short-term perinatal outcome. We aimed to study the effect of short (<6 months) and long (>60 months) IPI on long-term cardiovascular morbidity of the offspring. A population-based cohort study was performed in which all singleton live births in parturients with at least one previous birth were included. Hospitalizations of the offspring up to the age of 18 years involving cardiovascular diseases and according to IPI length were evaluated. Intermediate interval, between 6 and 60 months, was considered the reference. Kaplan–Meier survival curves were used to compare the cumulative morbidity incidence between the groups. Cox proportional hazards model was used to control for confounders. During the study period, 161,793 deliveries met the inclusion criteria. Of them, 14.1% (n = 22,851) occurred in parturient following a short IPI, 78.6% (n = 127,146) following an intermediate IPI, and 7.3% (n = 11,796) following a long IPI. Total hospitalizations of the offspring, involving cardiovascular morbidity, were comparable between the groups. The Kaplan–Meier survival curves demonstrated similar cumulative incidences of cardiovascular morbidity in all groups. In a Cox proportional hazards model, short and long IPI did not appear as independent risk factors for later pediatric cardiovascular morbidity of the offspring (adjusted HR 0.97, 95% CI 0.80–1.18; adjusted HR 1.01, 95% CI 0.83–1.37, for short and long IPI, respectively). In our population, extreme IPIs do not appear to impact long-term cardiovascular hospitalizations of offspring.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented in part at the 40th Annual Meeting of the Society of Maternal-Fetal Medicine, February 3–8, 2020 (abstract #173).

References

Shachar, BZ, Lyell, DJ. Interpregnancy interval and obstetrical complications. Obstet Gynecol Surv. 2012; 67(9), 584596.CrossRefGoogle ScholarPubMed
CM. Report of a WHO Technical Consultation on Birth Spacing, 2005. WHO, Geneva, Switzerland. Available at: www.who.int/reproductivehealth/publications/family_planning/WHO. Accessed March 18, 2012.Google Scholar
Conde-Agudelo, A, Rosas-Bermudez, A, Kafury-Goeta, AC. Birth spacing and risk of adverse perinatal outcomes: a meta-analysis. JAMA. 2006; 295(15), 18091823.CrossRefGoogle ScholarPubMed
Bakewell, JM, Stockbauer, JW, Schramm, WF. Factors associated with repetition of low birthweight: Missouri longitudinal study. Paediatr Perinat Epidemiol. 1997; 11(suppl 1), 119-129.CrossRefGoogle ScholarPubMed
Khoshnood, B, Lee, KS, Wall, S, et al. Short interpregnancy intervals and the risk of adverse birth outcomes among five racial/ethnic groups in the United States. Am J Epidemiol. 1998; 148, 798-805.CrossRefGoogle ScholarPubMed
Cheslack-Postava, K, Liu, K, Bearman, PS. Closely spaced pregnancies are associated with increased odds of autism in California sibling births. Pediatrics. 2011; 127, 246253.CrossRefGoogle ScholarPubMed
Kwon, S, Lazo-Escalante, M, Villaran, MV, Li, CI. Relationship between interpregnancy interval and birth defects in Washington State. J Perinatol. 2012; 32, 4550.CrossRefGoogle ScholarPubMed
Trogstad, LI, Eskild, A, Magnus, P, Samuelsen, SO, Nesheim, BI. Changing paternity and time since last pregnancy; the impact on pre-eclampsia risk. A study of 547 238 women with and without previous pre-eclampsia. Int J Epidemiol. 2001; 30, 13171322.CrossRefGoogle Scholar
Wainstock, T, Sergienko, R, Sheiner, E. Who is at risk for preeclampsia? Risk factors for developing initial preeclampsia in a subsequent pregnancy. J Clin Med. 2020; 9(4), 1103.CrossRefGoogle Scholar
Smith, GC, Pell, JP, Dobbie, R. Interpregnancy interval and risk of preterm birth and neonatal death: retrospective cohort study. BMJ. 2003; 327, 313.CrossRefGoogle ScholarPubMed
Smits, LJ, Essed, GG. Short interpregnancy intervals and unfavourable pregnancy outcome: role of folate depletion. Lancet. 2001; 358, 20742077.CrossRefGoogle ScholarPubMed
Davis, EF, Lazdam, M, Lewandowski, AJ, et al. Cardiovascular risk factors in children and young adults born to preeclamptic pregnancies: a systematic review. Pediatrics. 2012; 129, e1552e1561.CrossRefGoogle Scholar
Nahum Sacks, K, Friger, M, Shoham-Vardi, I, et al. Prenatal exposure to preeclampsia as an independent risk factor for long-term cardiovascular morbidity of the offspring. Pregnancy Hypertens. 2018; 13, 181186.CrossRefGoogle ScholarPubMed
Ratzon, R, Sheiner, E, Shoham-Vardi, I. The role of prenatal care in recurrent preterm birth. Eur J Obstet Gynecol Reprod Biol. 2011; 154(1), 4044.CrossRefGoogle ScholarPubMed
Lewandowski, AJ, Augustine, D, Lamata, P, et al. Preterm heart in adult life: cardiovascular magnetic resonance reveals distinct differences in left ventricular mass, geometry, and function. Circulation. 2013; 127, 197206.CrossRefGoogle ScholarPubMed
Localities in Israel. Central Bureau of Statistics Web Site. 2008–2017. https://www.cbs.gov.il/he/mediarelease/DocLib/2019/042/01_19_042b.pdf. Published February 06, 2019.Google Scholar
Abu-Ghanem, S, Sheiner, E, Sherf, M, et al. Lack of prenatal care in a traditional community: trends and perinatal outcomes. Arch Gynecol Obstet. 2012; 285(5), 12371242.CrossRefGoogle Scholar
Zhu, BP, Rolfs, RT, Nangle, BE, Horan, JM. Effect of the interval between pregnancies on perinatal outcomes. N Engl J Med. 1999; 340(8), 589594.CrossRefGoogle ScholarPubMed
Imterat, M, Wainstock, T, Sheiner, E, et al. Fertility treatments and the risk of pediatric obstructive sleep apnea in the offspring-results from a population-based cohort study. Pediatr Pulmonol. 2019; 54(10), 15341540.CrossRefGoogle ScholarPubMed
Levin, S, Sheiner, E, Wainstock, T, et al. Infertility treatments and long-term neurologic morbidity of the offspring. Am J Perinatol. 2019; 36(9), 949954.Google ScholarPubMed
Wainstock, T, Sheiner, E, Yoles, I, et al. Fertility treatments and offspring pediatric infectious morbidities: results of a population-based cohort with a median follow-up of 10 years. Fertil Steril. 2019; 112(6), 11291135.CrossRefGoogle ScholarPubMed
Krieger, Y, Wainstock, T, Sheiner, E, et al. Long-term pediatric skin eruption-related hospitalizations in offspring conceived via fertility treatment. Int J Dermatol. 2018; 57(3), 317323.CrossRefGoogle ScholarPubMed
Wainstock, T, Walfisch, A, Shoham-Vardi, I, et al. Fertility treatments and pediatric neoplasms of the offspring: results of a population-based cohort with a median follow-up of 10 years. Am J Obstet Gynecol. 2017; 216(3), 314.e1314.e14.CrossRefGoogle ScholarPubMed
Shachor, N, Wainstock, T, Sheiner, E, Harlev, A. Fertility treatments and gastrointestinal morbidity of the offspring. Early Hum Dev. 2020; 144, 105021.CrossRefGoogle ScholarPubMed
Scherrer, U, Rexhaj, E, Allemann, Y, Sartori, C, Rimoldi, SF. Cardiovascular dysfunction in children conceived by assisted reproductive technologies. Eur Heart J. 2015; 36, 15831589.CrossRefGoogle ScholarPubMed
Grisaru-Granovsky, S, Gordon, E-S, Haklai, Z, Samueloff, A, Schimmel, MM. Effect of interpregnancy interval on adverse perinatal outcomes--a national study. Contraception. 2009; 80(6), 512518.CrossRefGoogle ScholarPubMed
Thompson, JR, Carter, RL, Edwards, AR, et al. A population-based study of the effects of birth weight on early developmental delay or disability in children. Am J Perinatol. 2003; 20(6), 321332.Google ScholarPubMed
Gipson, JD, Koenig, MA, Hindin, MJ. The effects of unintended pregnancy on infant, child, and parental health: a review of the literature. Stud Fam Plann. 2008; 39(1), 1838.CrossRefGoogle ScholarPubMed
Cheng, D, Schwarz, EB, Douglas, E, Horon, I. Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors. Contraception. 2009; 79(3), 194198.CrossRefGoogle ScholarPubMed
Supplementary material: File

Imterat et al. supplementary material

Imterat et al. supplementary material 1

Download Imterat et al. supplementary material(File)
File 15.4 KB
Supplementary material: File

Imterat et al. supplementary material

Imterat et al. supplementary material 2

Download Imterat et al. supplementary material(File)
File 19 KB