title: Interpregnancy interval and perinatal outcomes across Latin America from 1990 to 2009: a large multi-country study.
abstract: OBJECTIVE
  To determine the relationship of interpregnancy interval with maternal and offspring outcomes.
  
  
  METHODS
  Retrospective study with data from the Perinatal Information System database of the Latin American Centre for Perinatology and Human Development, Uruguay.
  
  
  METHODS
  Latin America, 1990-2009.
  
  
  METHODS
  A cohort of 894 476 women delivering singleton infants.
  
  
  METHODS
  During 1990-2009 the Perinatal Information System database of the Latin American Centre for Perinatology identified 894 476 women with defined interpregnancy intervals: i.e. the time elapsed between the date of the previous delivery and the first day of the last normal menstrual period for the index pregnancy. Using the interval 12-23 months as the reference category, multiple logistic regression estimated adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) of the association between various interval lengths and maternal and offspring outcomes.
  
  
  METHODS
  Maternal death, pre-eclampsia, eclampsia, puerperal infection, fetal death, neonatal death, preterm birth, and low birthweight.
  
  
  RESULTS
  In the reference interval there was 0.05% maternal death, 1.00% postpartum haemorrhage, 2.80% pre-eclampsia, 0.15% eclampsia, 0.28% puerperal infection, 3.45% fetal death, 0.68% neonatal death, 12.33% preterm birth, and 9.73% low birthweight. Longer intervals had increased odds of pre-eclampsia (>72 months), fetal death (>108-119 months), and low birthweight (96-107 months). Short intervals of <12 months had increased odds of pre-eclampsia (aOR 0.80; 95% CI 0.76-0.85), neonatal death (aOR 1.18; 95% CI 1.08-1.28), and preterm birth (aOR 1.16; 95% CI 1.11-1.21). Statistically, the interval had no relationship with maternal death, eclampsia, and puerperal infection.
  
  
  CONCLUSIONS
  A short interpregnancy interval of <12 months is associated with pre-eclampsia, neonatal mortality, and preterm birth, but not with other maternal or offspring outcomes. Longer intervals of >72 months are associated with pre-eclampsia, fetal death, and low birthweight, but not with other maternal or offspring outcomes.
  
  
  CONCLUSIONS
  A short interpregnancy interval of <12 months is associated with neonatal mortality and preterm birth.
authors.affiliation: Centro Rosarino de Estudios Perinatales (CREP), Rosario, Argentina.
authors.forename: L E
authors.initials: LE
authors.lastname: Mignini
authors.affiliation: Centro Rosarino de Estudios Perinatales (CREP), Rosario, Argentina.
authors.forename: G
authors.initials: G
authors.lastname: Carroli
authors.affiliation: UNDP/UNFPA/WHO/World Bank Special Programme of Research Development and Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: A P
authors.initials: AP
authors.lastname: Betran
authors.affiliation: Centro Latinoamericano de Perinatología (CLAP), Montevideo, Uruguay.
authors.forename: R
authors.initials: R
authors.lastname: Fescina
authors.affiliation: Centro Rosarino de Estudios Perinatales (CREP), Rosario, Argentina.
authors.forename: C
authors.initials: C
authors.lastname: Cuesta
authors.affiliation: Centro Rosarino de Estudios Perinatales (CREP), Rosario, Argentina.
authors.forename: L
authors.initials: L
authors.lastname: Campodonico
authors.affiliation: Centro Latinoamericano de Perinatología (CLAP), Montevideo, Uruguay.
authors.forename: B
authors.initials: B
authors.lastname: De Mucio
authors.affiliation: Women's Health Research Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: K S
authors.initials: KS
authors.lastname: Khan
mesh_terms: D001721:Birth Intervals; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007843:Latin America / Q000453:epidemiology; D016015:Logistic Models; D008137:Longitudinal Studies; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: Fetal death; interpregnancy intervals; maternal death; perinatal; pre-eclampsia