Interpregnancy Interval Effect on Perinatal Outcome- A Prospective Observational Study
QC01-QC04
Correspondence
Subrata Samanta,
152-A, Gopal Lal Tagore Road, Kolkata-700108, West Bengal, India.
E-mail: drsubratasamanta@gmail.com
Introduction: Spacing of birth is an important parameter affecting maternal and foetal health. Optimal birth spacing provides multiple benefits for both mother and her child. Both short and long Interpregnancy Intervals (IPI) is associated with multiple adverse perinatal outcomes. Therefore, IPI is viewed as a potential modifiable risk factor for adverse foetal-maternal outcome.
Aim: To study the association of IPIs with adverse maternal and foetal outcomes.
Materials and Methods: This prospective observational study was conducted in R.G. Kar Medical College and Hospital, Kolkata, West Bengal, India for a period of 18 months from January 2019 to June 2020. All multigravida women with atleast three antenatal checkups were included in the study. The subjects were divided in two groups: group A consisted of 86 subjects, who had <2 year IPI and group B consisted of 87 subjects, who had ≥2 year IPI. These were compared on the basis of following socio-demographic characteristics: maternal age, Body Mass Index (BMI), contraceptive use, socio-economic status. Foetal outcome was assessed by gestational age at delivery, birth weight, Appearance, Pulse, Grimace, Activity and Respiration (APGAR) score, need for Neonatal Intensive Care Unit/Sick Neonatal Care Unit (NICU/SNCU) admission and perinatal morbidity and mortality. Data were collected and statistically analysed using Statistical Package for Social Science (SPSS) version 19.0 (SPSS Inc, Chicago, IL, USA). Chi-square test was used for categorical data and students t-test was used for continuous data. Statistical significance in all evaluations was defined as p-value <0.05.
Results: Contraception use were significantly less in women with short IPI (p=0.001). The incidence of anaemia (p=0.026), scar dehiscence in postcaesarean pregnancies (p=0.031) and Postpartum Haemorrhage (PPH) (p=0.041) were also higher in mothers with short IPI. In this group incidence of low-birth-weight baby (p=0.039), preterm birth (p=0.041) and need for care of babies in NICU (p=0.043) were also higher and was statistically significant.
Conclusion: Lack of contraceptive use significantly increases the risk of short IPI which increases the risk of preterm delivery, maternal anaemia PPH and scar rupture in post-CS pregnancy and therefore, has a serious impact on maternal morbidity. Low birth weight and NICU/SNCU admission being more in group A was a drain on the health expenditure.