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- Title
Interpregnancy interval and hypertensive disorders of pregnancy: A population-based cohort study.
- Authors
Gebremedhin, Amanuel T.; Regan, Annette K.; Ball, Stephen; Betrán, Ana P.; Foo, Damien; Gissler, Mika; Håberg, Siri E.; Malacova, Eva; Marinovich, Michael Luke; Pereira, Gavin
- Abstract
<bold>Background: </bold>Despite extensive research on risk factors and mechanisms, the extent to which interpregnancy interval (IPI) affects hypertensive disorders of pregnancy in high-income countries remains unclear.<bold>Objectives: </bold>To examine the association between IPI and hypertensive disorders of pregnancy in a high-income country setting using both within-mother and between-mother comparisons.<bold>Methods: </bold>A retrospective population-based cohort study was conducted among 103 909 women who delivered three or more consecutive singleton births (n = 358 046) between 1980 and 2015 in Western Australia. We used conditional Poisson regression with robust variance, matching intervals of the same mother and adjusted for factors that vary within-mother across pregnancies, to investigate the association between IPI categories (reference 18-23 months), and the risk of hypertensive disorders of pregnancy. For comparison with previous studies, we also applied unmatched Poisson regression (between-mother analysis).<bold>Results: </bold>The incidence of preeclampsia and gestational hypertension during the study period was 4%, and 2%, respectively. For the between-mother comparison, mothers with intervals of 6-11 months had lower risk of preeclampsia with adjusted relative risk (RR) 0.92 (95% confidence interval [CI] 0.85, 0.98) compared to reference category of 18-23 months. With the within-mother matched design, we estimated a larger effect of long IPI on risk of preeclampsia (RR 1.29, 95% CI 1.18, 1.42 for 60-119 months; and RR 1.30, 95% CI 1.10, 1.53 for intervals ≥120 months) compared to 18-23 months. Short IPIs were not associated with hypertensive disorders of pregnancy.<bold>Conclusions: </bold>In our cohort, longer IPIs were associated with increased risk of preeclampsia. However, there was insufficient evidence to suggest that short IPIs (<6 months) increase the risks of hypertensive disorders of pregnancy.
- Subjects
HYPERTENSIVE crisis; CARDIOVASCULAR diseases in pregnancy; CARDIOVASCULAR diseases; PREGNANCY complications; MATERNAL health
- Publication
Paediatric & Perinatal Epidemiology, 2021, Vol 35, Issue 4, p404
- ISSN
0269-5022
- Publication type
journal article
- DOI
10.1111/ppe.12668