title: Spectrum of maternal and perinatal outcomes among parturient women with preceding short inter-pregnancy interval at Bugando Medical Centre, Tanzania.
abstract: BACKGROUND
  Traditionally women with a short inter-pregnancy interval will not have sufficient time to recover and get ready for the subsequent pregnancy. This includes socio-economic, cultural, psychological and physical body preparedness. The present study aimed at comparing the maternal and perinatal outcomes among parturient women with preceding short and normal inter-pregnancy interval attending at Bugando Medical Centre (BMC). This was a prospective cohort study. It was done from November 2012 to April 2013. Multiple matching design approach was used to adjust for age variable during selection of participants. Chi-square test and Relative Risk (RR) were calculated to test for strength of association between variables.
  
  
  RESULTS
  Four hundred and fifty (450) women were recruited in this study in which 150 had a SIPI and 300 had a NIPI. The premature rupture of membrane (PROM) was higher [RR = 13.6; 95% CI 7.2 - 25.6] among SIPI women than in NIPI women [RR = 0.57; 95% CI 0.49-0.7]. Women with a SIPI were found to have a significantly higher risk for anemia (RR = 3.4) compared to those with a NIPI (RR = 0.08). SIPI women had a higher risk for failure of trial of vaginal birth after caesarean section (VBAC) (RR = 14.7; 95% CI 6.4 - 33.6) compared to NIPI (RR = 0.72; 95% CI 0.65-0.8). The risk of postpartum hemorrhage (PPH) was higher among SIPI women (RR = 5.8) compared to women of NIPI (RR = 0.83). Women with SIPI had higher risk for small for gestation age (SGA) babies (RR = 7.7; 95% CI 3.8-15.7), low birth weight (RR = 6.7; 95% CI 3.6-12.3), preterm delivery (RR = 9.78; 95% CI 4.9-19.5) and low Apgar score (RR = 6.9; 95% CI 0.7-0.8) compared to women in NIPI.
  
  
  CONCLUSIONS
  Higher risk for PROM, anemia, failure of trial of VBAC, PPH and preeclampsia were observed among women with SIPI. Babies born of mothers with a SIPI were significantly at higher risk for SGA, low birth weight, low Apgar score, preterm deliveries compared to women in NIPI. Birth spacing, creating more awareness of complications, on risks associated with SIPI and provision of folate supplements should be advocated.
authors.affiliation: Department of Obstetrics & Gynecology, Catholic University of Health & Allied sciences, P.O. BOX 1464, Mwanza, Tanzania.
authors.forename: Athanase
authors.initials: A
authors.lastname: Lilungulu
authors.affiliation: Department of Obstetrics & Gynecology, Catholic University of Health & Allied sciences, P.O. BOX 1464, Mwanza, Tanzania.
authors.forename: Dismas
authors.initials: D
authors.lastname: Matovelo
authors.affiliation: Department of Obstetrics & Gynecology, Catholic University of Health & Allied sciences, P.O. BOX 1464, Mwanza, Tanzania ; Department of Obstetrics & Gynecology, Bugando Medical Centre, P.O. BOX 1370, Mwanza, Tanzania.
authors.forename: Albert
authors.initials: A
authors.lastname: Kihunrwa
authors.affiliation: Department of Obstetrics & Gynecology, Catholic University of Health & Allied sciences, P.O. BOX 1464, Mwanza, Tanzania ; Department of Obstetrics & Gynecology, Bugando Medical Centre, P.O. BOX 1370, Mwanza, Tanzania.
authors.forename: Balthazar
authors.initials: B
authors.lastname: Gumodoka
keywords: Maternal and perinatal outcome; Normal inter-pregnancy interval; Short inter-pregnancy interval