title: A short interpregnancy interval is a risk factor for preterm birth and its recurrence.
abstract: OBJECTIVE
  We tested the hypothesis that short interpregnancy intervals (IPIs) increase the risk for preterm birth (PTB), recurrence of PTB, and delivery at early extremes of gestational age.
  
  
  METHODS
  Using the Missouri Department of Health's birth certificate database, we performed a population-based cohort study of 156,330 women who had 2 births from 1989-1997. The association between IPI and subsequent pregnancy outcome was assessed.
  
  
  RESULTS
  The shortest IPIs (<6 months) increased the risk of extreme PTB (adjusted odds ratio, 1.41; 95% CI, 1.13-1.76). IPIs of <6 months and 6-12 months increased the overall risk of PTB (adjusted odds ratios, 1.48 [95% CI, 1.37-1.61] and 1.14 [95% CI, 1.06-1.23], respectively) and PTB recurrence (adjusted odds ratios, 1.44 [95% CI, 1.19-1.75] and 1.24 [95% CI, 1.02-1.50], respectively).
  
  
  CONCLUSIONS
  The risk of PTB and its recurrence increases with short IPIs, even after adjustment for coexisting risk factors. This highlights the importance of counseling women with either an initial term or preterm birth to wait at least 12 months between delivery and subsequent conception.
authors.affiliation: Department of Obstetrics and Gynecology and the Center for Preterm Birth Research, Washington University School of Medicine, St. Louis, MO 63110, USA. defrancoe@wudosis.wustl.edu
authors.forename: Emily A
authors.initials: EA
authors.lastname: DeFranco
authors.forename: David M
authors.initials: DM
authors.lastname: Stamilio
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Boslaugh
authors.forename: Gilad A
authors.initials: GA
authors.lastname: Gross
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Muglia
mesh_terms: D000328:Adult; D001721:Birth Intervals; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors