Does Intervening Pregnancy Loss Impact Adverse Pregnancy Events Associated with Short or Long Interpregnancy Intervals?
BACKGROUND AND PURPOSE:
Ignoring intervening miscarriage early in pregnancy may lead to overestimation of intervals between pregnancies
Tessema et al. (BJOG, 2022) investigated whether intervening miscarriages and induced abortions impact the associations between adverse pregnancy outcomes and either short or long interpregnancy intervals
Population-based retrospective cohort study
3 mandatory national Norwegian registries
Births to women between 2008 and 2016
Miscarriages and induced abortions in the interpregnancy interval (IPI)
Adjusted relative risks (aRR) estimated for adverse pregnancy outcomes using regression analysis
Conventional IPI estimates: Ignoring miscarriages and induced abortions in the IPI estimation
Correct IPI estimates: Accounting for intervening miscarriages or induced abortions
The ratio of ratios (RoR) was used to compare the 2 estimates and was defined as the aRR with conventional IPI divided by aRR with correct IPI
Adverse pregnancy outcomes
165,617 births | 143,916 women
There was no significant difference in the following when the interpregnancy interval was short (<6 months) vs 18 to 23 months
Preterm birth: RoR: 0.97 (95% CI, 0.83 to 1.13)
Spontaneous preterm birth: RoR 0.97 (95% CI, 0.80 to 1.19)
Small for gestational age: RoR 1.00 (95% CI, 0.86 to 1.10)
Large for gestational age: RoR 1.00 (95% CI, 0.90 to 1.10)
Preeclampsia: RoR 0.99 (95% CI, 0.71 to 1.37)
Both conventional and correct IPIs yielded associations of similar magnitude between long interpregnancy interval (≥60 months) and the pregnancy outcomes evaluated
When intervening pregnancy loss is ignored, there is a negligible difference in the risk of adverse pregnancy outcomes, for both short or long interpregnancy interval
The authors state
Our results indicate that not considering intervening pregnancy loss resulted in no meaningful differences in the observed risk of adverse pregnancy outcomes associated with short and long IPIs following live births
Our findings are reassuring for researchers estimating IPI without accounting for intervening miscarriages or induced abortions when there is no available information on these events
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan