THE EFFECTS OF INTER-PREGNANCY INTERVAL ON BIRTH OUTCOME

Sanji Samsu Allen (sanjiallen@yahoo.com)
Gynaecology-Obstetrics, The University of Yaounde 1
June, 2017
 

Abstract

Introduction:
Abnormal (short) inter-pregnancy interval is known to have negative effects on birth outcome. Women with abnormal inter-pregnancy interval do not have sufficient time to recover and get ready for the next pregnancy. Our context of cultural diversity and traditional beliefs that a woman can get pregnant as soon as possible after delivery motivated the study.
Objectives: The study aims to evaluate the effects of abnormal inter-pregnancy interval on birth outcome.
Methodology:
A cross-sectional analytic study was carried out from November 2016 till April 2017 in the gynaecological services of the Yaounde central hospital and the Yaounde gyneco-obstetric and pediatric hospital. Women who came to give birth during the study period were assigned into two groups, those with normal inter-pregnancy interval (≥24 months) and those with abnormal inter-pregnancy interval (<24 months). Labor was managed in the same manner (using the partogram from 4cm cervical dilatation) and delivery was conducted in the same manner. Outcomes were compared amongst these groups.
Results:
There were 100 parturients in each group giving a total of 200 parturients. Pre ecampsia was more amongst parturients with abnormal inter-pregnancy interval (AIPI) than in parturients with normal inter-pregnancy interval [OR 6.6, 95% CI 1.4-30.6, p = 0.01]. Premature rupture of membranes (PROM) was higher amongst parturients with AIPI as compared with parturients with normal inter-pregnancy interval (NIPI), [OR 2.5, 95% CI 1.0-5.8, p = 0.03]. There was no significant difference in postpartum haemorrhage in both groups [OR 1.2, 95% CI 0.4-3.3, p = 0.6]. Caesarean delivery was more amongst women with AIPI than women with NIPI (OR 4.5, 95% CI 2.4-8.2) p<0.001. Infants with birth weight < 2500g were more in the group of parturients with AIPI as against parturients with NIPI [OR 1.9, 95% CI 1.0-3.6, p = 0.04]. Low Apgar score was more amongst parturients with AIPI as against parturients with NIPI [OR 2.1, 95% CI 1.1-3.9, p = 0.2].
Pretem birth was also well higher in the group of parturients with AIPI than parturients with NIPI [OR 2.3, 95% CI 1.2-4.5, p <0.01]. Still birth was more in the group of parturients with AIPI than parturients with NIPI [OR 2.5, 95% CI 1.0-6.1, p = 0.04].
Conclusion:
Higher risk of pre-eclampsia, premature rupture of membranes and caesarean delivey were more in parturients with abnormal inter-pregnancy interval (AIPI). Babies born to parturients with AIPI were at higher risk of low birth weight, preterm birth, low Apgar score and still birth as compared to parturients with normal inter-pregnancy interval (NIPI).
Recommendation:
More awareness should be created on the disadvantages of abnormal inter-pregnancy interval.
Keywords: Inter-pregnancy, interval, abnormal, Yaounde.


********************************************************************************************