Long and short interpregnancy interval increases severe mate
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Severe maternal morbidity (SMM) is a composite variable that includes adverse maternal outcomes during pregnancy that are associated with maternal mortality. Increased risk of SMM is associated with women having short interpregnancy interval (IPI) and long IPI.

Investigators sought to determine the relationship between interpregnancy interval (IPI) stratified as <6 months, 6-11 months, 12-17 months, 18-23 months, 24-59 months, and ≥60 months and SMM, which we considered both with and without blood transfusion.

This is a retrospective cohort study of multiparous women 15-54 years old with singleton, non-anomalous births between 23-42 weeks gestation in California. Researchers defined SMM as the composite score of a published list of ICD-9 diagnoses and procedure codes, provided by the CDC. They used chi-square tests for categorical variables and multivariable logistic regression models were utilized to determine the association of IPI with SMM, adjusted for maternal race/ethnicity, age, education, body mass index, insurance, prenatal care, smoking status, and maternal co-morbidity index score.

--In this study, 1,669,912 women met inclusion criteria and of these, 0.87% of women had SMM and 0.28% had ntSMM.

--Multivariable logistic regression models showed that compared to women with 18-23 months IPI, women with IPI of less than 6 months and ≥60 months had significantly higher adjusted odds of SMM.

--Odds of ntSMM are higher in women with long IPI after controlling for the same potential confounders.

--They also found significantly higher odds of requiring ventilation and maternal sepsis in women with long IPI.

In summary, the risk of SMM is higher in women with short IPI (<6 months) and long IPI (≥60 months) as compared to normal IPI (18-23 months). The risk of ntSMM is significantly higher in women with long IPI (≥60 months).

Source: https://doi.org/10.1016/j.ajog.2021.05.013
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