Inter-pregnancy interval and long-term neurological morbidity of the offspring

Arch Gynecol Obstet. 2021 Mar;303(3):703-708. doi: 10.1007/s00404-020-05788-9. Epub 2020 Sep 15.

Abstract

Purpose: The purpose of our study was to evaluate the effect of IPI on long-term neurological morbidity of the offspring.

Methods: In this retrospective cohort study, 144,397 singleton infants born to multiparous mothers, between the years 1991 and 2014 in a tertiary medical center, were evaluated for different perinatal outcomes and were followed until 18 years of age for long-term neurological morbidity according to three IPI groups: Short IPI (< 6 months), long IPI (> 60 months) and intermediate IPI (6-60 months). We used a Kaplan-Meier survival curve to compare cumulative incidence of long-term neurological morbidity, and a Cox regression analysis to control for confounders such as gestational age, birth weight and maternal age.

Results: Offspring born to mothers with long IPI had higher rates of neurological morbidity (3.62% among offspring born after long IPI vs. 3.18% and 3.19% among offspring born after short and intermediate IPI, respectively, p = 0.041). The cumulative incidence of long-term neurological morbidity was significantly higher in the long IPI group (Kaplan-Meier log-rank test p < 0.001). Being born after a long IPI was found to be an independent risk factor for long-term neurological morbidity of the offspring (adjusted hazard ratio 1.2; 95% confidence interval 1.1-1.4; p < 0.001).

Conclusion: Long IPI is independently associated with an increased risk of long-term neurological morbidity of the offspring.

Keywords: Interpregnancy interval; Long-term; Neurological disease; Neurological morbidity; Offspring.

MeSH terms

  • Adult
  • Birth Intervals*
  • Cohort Studies
  • Female
  • Gestational Age
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Israel / epidemiology
  • Kaplan-Meier Estimate
  • Male
  • Maternal Age
  • Mothers / statistics & numerical data*
  • Nervous System Diseases / epidemiology*
  • Parturition
  • Pregnancy
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors