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The association between interpregnancy interval and severe maternal morbidities using revised national birth certificate data: A probabilistic bias analysis
Background Severe maternal morbidity continues to be on the rise in the US. Short birth spacing is a modifiable risk factor associated with maternal morbidity, yet few studies have examined this association, possibly due to few available data sources to examine these rare events. Objective To examin...
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| Published in: | Paediatric and perinatal epidemiology 2020-07, Vol.34 (4), p.469-480 |
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| Language: | English |
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| container_title | Paediatric and perinatal epidemiology |
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| creator | De Silva, Dane A. Thoma, Marie E. |
| description | Background
Severe maternal morbidity continues to be on the rise in the US. Short birth spacing is a modifiable risk factor associated with maternal morbidity, yet few studies have examined this association, possibly due to few available data sources to examine these rare events.
Objective
To examine the association between interpregnancy interval (IPI) and severe maternal morbidity using near‐national birth certificate data and account for known under‐reporting using probabilistic bias analysis.
Methods
We used revised 2014‐2017 birth certificate data, restricting to resident women with a non–first‐born singleton birth. We examined the following: (a) maternal blood transfusion, (b) admission to intensive care unit (ICU), (c) uterine rupture (among women with a prior caesarean delivery) and (d) third‐ or fourth‐degree perineal laceration (among vaginal deliveries) by IPI categories ( |
| doi_str_mv | 10.1111/ppe.12560 |
| format | article |
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Severe maternal morbidity continues to be on the rise in the US. Short birth spacing is a modifiable risk factor associated with maternal morbidity, yet few studies have examined this association, possibly due to few available data sources to examine these rare events.
Objective
To examine the association between interpregnancy interval (IPI) and severe maternal morbidity using near‐national birth certificate data and account for known under‐reporting using probabilistic bias analysis.
Methods
We used revised 2014‐2017 birth certificate data, restricting to resident women with a non–first‐born singleton birth. We examined the following: (a) maternal blood transfusion, (b) admission to intensive care unit (ICU), (c) uterine rupture (among women with a prior caesarean delivery) and (d) third‐ or fourth‐degree perineal laceration (among vaginal deliveries) by IPI categories (<6, 6‐11, 12‐17, 18‐23, 24‐59 and 60+ months). Risk ratios and 95% confidence intervals were estimated using log‐binomial regression, adjusting for select maternal characteristics. Probabilistic bias analyses were performed.
Results
Compared with IPI 18 to 23 months, adjusted models revealed that the risk of maternal transfusion followed a U‐shaped curve with IPI, while risk of ICU admission and perineal laceration increased with longer IPI. Risk of uterine rupture was highest among IPI <6 months. With the exception of maternal transfusion, these findings persisted regardless of the extent or type of misclassification examined in bias analyses.
Conclusions
Associations between IPI and maternal morbidity varied by outcome, even after adjusting for misclassification of SMM. Differences across maternal health outcomes should be considered when counselling and making recommendations regarding optimal birth spacing.</description><identifier>ISSN: 0269-5022</identifier><identifier>EISSN: 1365-3016</identifier><identifier>DOI: 10.1111/ppe.12560</identifier><identifier>PMID: 31231858</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Bias ; Birth ; birth certificate ; Birth certificates ; birth spacing ; Blood transfusion ; Confidence intervals ; Health risk assessment ; interpregnancy interval ; maternal morbidity ; Morbidity ; probabilistic bias ; Probabilistic methods ; Risk analysis ; Risk factors ; Rupture ; Rupturing ; Statistical analysis ; Transfusion ; Uterus ; Vagina</subject><ispartof>Paediatric and perinatal epidemiology, 2020-07, Vol.34 (4), p.469-480</ispartof><rights>2019 John Wiley & Sons Ltd</rights><rights>2019 John Wiley & Sons Ltd.</rights><rights>Copyright © 2020 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3530-4407f0b4c19a83482c7772f0bf80369f09f53020f2b1c8baa782529b31147303</citedby><cites>FETCH-LOGICAL-c3530-4407f0b4c19a83482c7772f0bf80369f09f53020f2b1c8baa782529b31147303</cites><orcidid>0000-0001-9267-4384 ; 0000-0001-6558-2716</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31231858$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>De Silva, Dane A.</creatorcontrib><creatorcontrib>Thoma, Marie E.</creatorcontrib><title>The association between interpregnancy interval and severe maternal morbidities using revised national birth certificate data: A probabilistic bias analysis</title><title>Paediatric and perinatal epidemiology</title><addtitle>Paediatr Perinat Epidemiol</addtitle><description>Background
Severe maternal morbidity continues to be on the rise in the US. Short birth spacing is a modifiable risk factor associated with maternal morbidity, yet few studies have examined this association, possibly due to few available data sources to examine these rare events.
Objective
To examine the association between interpregnancy interval (IPI) and severe maternal morbidity using near‐national birth certificate data and account for known under‐reporting using probabilistic bias analysis.
Methods
We used revised 2014‐2017 birth certificate data, restricting to resident women with a non–first‐born singleton birth. We examined the following: (a) maternal blood transfusion, (b) admission to intensive care unit (ICU), (c) uterine rupture (among women with a prior caesarean delivery) and (d) third‐ or fourth‐degree perineal laceration (among vaginal deliveries) by IPI categories (<6, 6‐11, 12‐17, 18‐23, 24‐59 and 60+ months). Risk ratios and 95% confidence intervals were estimated using log‐binomial regression, adjusting for select maternal characteristics. Probabilistic bias analyses were performed.
Results
Compared with IPI 18 to 23 months, adjusted models revealed that the risk of maternal transfusion followed a U‐shaped curve with IPI, while risk of ICU admission and perineal laceration increased with longer IPI. Risk of uterine rupture was highest among IPI <6 months. With the exception of maternal transfusion, these findings persisted regardless of the extent or type of misclassification examined in bias analyses.
Conclusions
Associations between IPI and maternal morbidity varied by outcome, even after adjusting for misclassification of SMM. Differences across maternal health outcomes should be considered when counselling and making recommendations regarding optimal birth spacing.</description><subject>Bias</subject><subject>Birth</subject><subject>birth certificate</subject><subject>Birth certificates</subject><subject>birth spacing</subject><subject>Blood transfusion</subject><subject>Confidence intervals</subject><subject>Health risk assessment</subject><subject>interpregnancy interval</subject><subject>maternal morbidity</subject><subject>Morbidity</subject><subject>probabilistic bias</subject><subject>Probabilistic methods</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Rupture</subject><subject>Rupturing</subject><subject>Statistical analysis</subject><subject>Transfusion</subject><subject>Uterus</subject><subject>Vagina</subject><issn>0269-5022</issn><issn>1365-3016</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kc1O3TAQha2qFVwoi75AZambdhHwT-Ik3SFEaSWksrj7yHYmYJQ4qSe56L4LD9uB0C6Q8Gbko2_OjOYw9kmKU0nvbJrgVKrCiHdsI7UpMi2kec82Qpk6K4RSh-wI8V4IYYpaHbBDLZWWVVFt2OP2DrhFHH2wcxgjdzA_AEQe4gxpSnAbbfT79buzPbex5Qg7SMAHS1okbRiTC22YAyBfMMRbnmAXEFoen00JcSHNd9xDmkMXPDXy1s72Oz_nUxqddaEPOAdPnEWaYfs9BvzIPnS2Rzh5qcds--Nye_Ezu_599evi_DrzutAiy3NRdsLlXta20nmlfFmWipSuEtrUnag7wpTolJO-ctaWlSpU7bSUeamFPmZfV1ta5c8CODdDQA99byOMCzZK5UbRDJET-uUVej8uTzcgKpdG0sVNTdS3lfJpREzQNVMKg037RormKbGGEmueEyP284vj4gZo_5P_IiLgbAUeQg_7t52am5vL1fIvR5ahmQ</recordid><startdate>202007</startdate><enddate>202007</enddate><creator>De Silva, Dane A.</creator><creator>Thoma, Marie E.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9267-4384</orcidid><orcidid>https://orcid.org/0000-0001-6558-2716</orcidid></search><sort><creationdate>202007</creationdate><title>The association between interpregnancy interval and severe maternal morbidities using revised national birth certificate data: A probabilistic bias analysis</title><author>De Silva, Dane A. ; Thoma, Marie E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3530-4407f0b4c19a83482c7772f0bf80369f09f53020f2b1c8baa782529b31147303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Bias</topic><topic>Birth</topic><topic>birth certificate</topic><topic>Birth certificates</topic><topic>birth spacing</topic><topic>Blood transfusion</topic><topic>Confidence intervals</topic><topic>Health risk assessment</topic><topic>interpregnancy interval</topic><topic>maternal morbidity</topic><topic>Morbidity</topic><topic>probabilistic bias</topic><topic>Probabilistic methods</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Rupture</topic><topic>Rupturing</topic><topic>Statistical analysis</topic><topic>Transfusion</topic><topic>Uterus</topic><topic>Vagina</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>De Silva, Dane A.</creatorcontrib><creatorcontrib>Thoma, Marie E.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Paediatric and perinatal epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>De Silva, Dane A.</au><au>Thoma, Marie E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The association between interpregnancy interval and severe maternal morbidities using revised national birth certificate data: A probabilistic bias analysis</atitle><jtitle>Paediatric and perinatal epidemiology</jtitle><addtitle>Paediatr Perinat Epidemiol</addtitle><date>2020-07</date><risdate>2020</risdate><volume>34</volume><issue>4</issue><spage>469</spage><epage>480</epage><pages>469-480</pages><issn>0269-5022</issn><eissn>1365-3016</eissn><abstract>Background
Severe maternal morbidity continues to be on the rise in the US. Short birth spacing is a modifiable risk factor associated with maternal morbidity, yet few studies have examined this association, possibly due to few available data sources to examine these rare events.
Objective
To examine the association between interpregnancy interval (IPI) and severe maternal morbidity using near‐national birth certificate data and account for known under‐reporting using probabilistic bias analysis.
Methods
We used revised 2014‐2017 birth certificate data, restricting to resident women with a non–first‐born singleton birth. We examined the following: (a) maternal blood transfusion, (b) admission to intensive care unit (ICU), (c) uterine rupture (among women with a prior caesarean delivery) and (d) third‐ or fourth‐degree perineal laceration (among vaginal deliveries) by IPI categories (<6, 6‐11, 12‐17, 18‐23, 24‐59 and 60+ months). Risk ratios and 95% confidence intervals were estimated using log‐binomial regression, adjusting for select maternal characteristics. Probabilistic bias analyses were performed.
Results
Compared with IPI 18 to 23 months, adjusted models revealed that the risk of maternal transfusion followed a U‐shaped curve with IPI, while risk of ICU admission and perineal laceration increased with longer IPI. Risk of uterine rupture was highest among IPI <6 months. With the exception of maternal transfusion, these findings persisted regardless of the extent or type of misclassification examined in bias analyses.
Conclusions
Associations between IPI and maternal morbidity varied by outcome, even after adjusting for misclassification of SMM. Differences across maternal health outcomes should be considered when counselling and making recommendations regarding optimal birth spacing.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31231858</pmid><doi>10.1111/ppe.12560</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-9267-4384</orcidid><orcidid>https://orcid.org/0000-0001-6558-2716</orcidid></addata></record> |
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| ispartof | Paediatric and perinatal epidemiology, 2020-07, Vol.34 (4), p.469-480 |
| issn | 0269-5022 1365-3016 |
| language | eng |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Bias Birth birth certificate Birth certificates birth spacing Blood transfusion Confidence intervals Health risk assessment interpregnancy interval maternal morbidity Morbidity probabilistic bias Probabilistic methods Risk analysis Risk factors Rupture Rupturing Statistical analysis Transfusion Uterus Vagina |
| title | The association between interpregnancy interval and severe maternal morbidities using revised national birth certificate data: A probabilistic bias analysis |
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