Impact of short inter-pregnancy interval on pregnancy outcome in a low-income country

Article type
Authors
Ugwu E1, Onwuka C1, Samuel O1, Benjamin O1
1Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Enugu Campus, Nigeria/University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu state, Nigeria
Abstract
Background:Short inter-pregnancy interval (IPI) could have an adverse influence on pregnancy outcome especially in low-income countries. Previous researchers from sub-Saharan Africa have documented an alarming trend of short IPI but evidence is lacking on its impact on pregnancy outcome.

Objectives: To determine the impact of short IPI on pregnancy outcome in Nigeria.

Methods:This was a longitudinal study of 271 eligible, pregnant women receiving antenatal care in a tertiary hospital in Nigeria. For every consecutive pregnant woman with short IPI (< 18 months) recruited into the study; a suitable control (matched for age, parity and social class) with IPI ≥ 18 months was recruited. Data collected included socio-demographic data, IPI, current pregnancy history, gestational age, and any adverse pregnancy or perinatal outcomes. Hypotheses were tested using logistic-regression analysis where applicable. All tests were two sided, and statistical significance was considered to be at probability value of < 0.05.

Results:The mean age of the participants was 31.6 ± 4.2 years, and the mean neonatal birth weight was 3.3 ± 0.6kg. The prevalence of maternal anaemia was significantly higher in women with short IPI than in the control group (OR: 3.0; 95% CI: 1.76 – 5.09; P < 0.001). Other maternal and perinatal outcome measures including poor maternal weight gain, premature rupture of membranes, preterm labour, pregnancy-induced hypertension, third-trimester bleeding, primary postpartum haemorrhage, preterm birth, stillbirth, birth asphyxia, and low birth weight had no significant association with short IPI (P > 0.05).

Conclusions:Short IPI is associated with anaemia in pregnancy in Nigeria. However, further research with larger sample sizes and preferably randomised-controlled trials are needed to provide sound evidence on the impact of short IPI on maternal outcome in low-income countries.