INTERPREGNANCY INTERVAL AND PREGNANCY OUTCOMES AMONG POSTPARTUM MOTHERS: FACILITY BASED CROSS SECTIONAL STUDY
Abstract
Background
Non optimal (short or long) interpregnancy interval is one of common modifiable obstetric factors which is associated with multiple maternal, obstetric and fetal adverse outcomes such as preeclampsia, 3rd trimester bleeding, anemia, preterm delivery, low birth weight, small for gestational age and low APGAR score. There are few studies in our set up which assess interpregnancy interval and bad pregnancy outcomes. The aim of this study is to assess the prevalence of interpregnancy intervals (long and short) and to determine association of non-optimal (short and long) interpregnancy interval and bad pregnancy outcomes (maternal &obstetric and fetal) among postnatal mothers at St. Paul’s Hospital Millennium Medical College.
Methods
Facility based cross sectional analytic study was utilized from March 1-June 30, 2021. Convenient sampling technique was used to enroll 394 postnatal mothers who delivered at SPHMMC. Data was collected using an interview and chart review by a structured pretested questionnaire. Univariate descriptive analysis was presented with frequency and percentage table, bivariate and multivariate analysis was done to assess association of non-optimal interpregnancy and composite bad maternal/obstetric and fetal outcomes. Composite fetal outcome is dichotomized as bad (if “Yes” to any of the following: SGA, LBW, Preterm delivery, low APGAR score and NICU admission) and good (if “No” to all of the above mentioned outcomes). Maternal and obstetric composite outcome is dichotomized as bad (if “Yes” to one of the following: hypertensive disorders of pregnancy, PROM, APH, Anemia or uterine dehiscence/rupture) or good (if “No to all of the above components). AOR with 95% CI is measured to show association between independent variables and dependent variable with strength of association to be significant when p-value is <0.05
Results
Prevalence of short and long interpregnancy (IPI) interval is 41.9% and 9.4% respectively. Those mothers with short IPI are found to have a 77% higher likelihood of a bad composite maternal pregnancy outcome compared to mothers with optimal IPI [AOR 1.77, 95%CI (1.106-2.832)].].Mothers with long IPI have 2.9 times likelihood of having bad composite neonatal outcome compared with mothers with optimal IPI [AOR 2.89, 95%CI (1.350-6.208), p-value=0.06].
Conclusion
Short interpregnancy interval is significantly associated with bad composite maternal and obstetric outcomes compared to optimal interpregnancy interval. However, it is not significantly associated with composite bad neonatal outcome except small for SGA. On the other hand, long interpregnancy interval is associated with bad composite neonatal outcome but not with composite neonatal outcome.