Interpregnancy and interbirth intervals and all-cause, cardiovascular-related and cancer-related maternal mortality: Findings from a large population-based cohort study

Yiska Loewenberg Weisband*, Orly Manor, Yechiel Friedlander, Hagit Hochner, Ora Paltiel, Ronit Calderon-Margalit

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction Scarce research is available regarding the association between interbirth intervals (IBI) and long-term maternal health outcomes, particularly cardiovascular disease (CVD) mortality. We aimed to assess whether IBIs were associated with all-cause, CVD-related and cancer-related mortality. Methods We conducted a cohort study in the setting of the Jerusalem Perinatal Study. Women with at least two consecutive singleton live births in 1964-1976 (N=18 294) were followed through 2016. IBIs were calculated as the interval between women's first and second cohort birth. We estimated associations between IBIs and mortality using Cox's proportional hazards models, adjusting for age, parity, maternal education, maternal origin and paternal socioeconomic status. Date of last menstrual period was available for a subset of women. We assessed the interpregnancy interval (IPI) for these women and compared the models using IPI and IBI. Results During 868 079 years of follow up (median follow-up: 49.0 years), 3337 women died. Women with IBIs <15 months had higher all-cause mortality rates (HR 1.18; 95% CI 1.05 to 1.33) compared to women with 33-month to 68-month IBIs (reference category). IBI and CVD mortality appeared to have a J-shaped association; IBIs of <15, 15-20, 21-2626-2632, 33-68 and ≥69 months had HRs of 1.44, 1.40, 1.33, 1.14, 1.00 and 1.30, respectively. No substantial association was found with cancer mortality. Models using IPIs and those using IBI were similar. Conclusion Our results support the WHO recommendations for IPIs of ≥24 months and add additional evidence regarding long-term CVD mortality.

Original languageAmerican English
Pages (from-to)957–963
Number of pages7
JournalJournal of Epidemiology and Community Health
Volume74
Issue number11
DOIs
StatePublished - Nov 2020

Bibliographical note

Publisher Copyright:
© 2020 Author(s).

Keywords

  • EPIDEMIOLOGY
  • Lifecourse/ Childhood Circumstances
  • MATERNAL HEALTH
  • MIDWIFERY
  • SOCIAL INEQUALITIES

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