Association between interpregnancy interval and hypertensive disorders of pregnancy: Effect modification by maternal age

Amanuel T. Gebremedhin, Gizachew A. Tessema, Annette K. Regan, Gavin Pereira

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: Short and long interpregnancy intervals (IPI) are associated with increased risk of hypertensive disorders of pregnancy, yet whether this association is modified by maternal age remains unclear. Objectives: To examine if the association between IPI and hypertensive disorders of pregnancy varies by maternal age at birth prior to IPI. Methods: We conducted a population-based cohort study of all mothers who had their first two (n = 169 896) consecutive births in Western Australia (WA) between 1980 and 2015. We estimated the risk of preeclampsia and gestational hypertension for 6 to 60 months of IPI according to maternal age at birth prior to IPI (<20 years, 20-24, 25-29, 30-34 and ≥35 years). We modelled IPI using restricted cubic splines and reported adjusted relative risk (RRs) with 95% CI at 6, 12, 24, 36, 48 and 60 months, with 18 months as reference. Results: The risk of preeclampsia was increased at longer IPIs (60 months) compared to 18 months for mothers 35 years or older (RR 2.19, 95% confidence interval (CI) 1.14, 4.18) and to a lesser extent for mothers 30- to 34 years old (RR 1.43, 95% CI 1.10, 1.84). Compared to 18 months, the risk of preeclampsia was lower at 12 months of IPI for mothers younger than 20 years (RR 0.74, 95% CI 0.57, 0.96), but not for mothers 35 years or older (RR 0.62, 95% CI 0.36, 1.07). There was insufficient evidence for increased risk of hypertensive disorders of pregnancy at shorter IPIs of <18 months for mothers of all ages. Conclusions: Our findings challenge the “one size fits all” recommendation for an optimal IPI, and a more tailored approach to family planning counselling may be required to improve health.

Original languageEnglish
JournalPaediatric and Perinatal Epidemiology
DOIs
Publication statusE-pub ahead of print - 15 Jun 2021

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