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

IntroductionScarce 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....

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Published in:Journal of epidemiology and community health (1979) 2020-11, Vol.74 (11), p.957-963
Main Authors: Weisband, Yiska Loewenberg, Manor, Orly, Friedlander, Yechiel, Hochner, Hagit, Paltiel, Ora, Calderon-Margalit, Ronit
Format: Article
Language:English
Subjects:
Age
Births
Cancer
Cardiovascular diseases
Cohort analysis
Education
EPIDEMIOLOGY
Lifecourse/ Childhood Circumstances
Maternal & child health
MATERNAL HEALTH
Maternal mortality
Menstruation
MIDWIFERY
Mortality
Original research
Parent educational background
Population
Population studies
Population-based studies
Preeclampsia
Pregnancy
SOCIAL INEQUALITIES
Socioeconomic factors
Socioeconomics
Variables
Variance analysis
Womens health
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container_issue 11
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container_title Journal of epidemiology and community health (1979)
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creator Weisband, Yiska Loewenberg
Manor, Orly
Friedlander, Yechiel
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Paltiel, Ora
Calderon-Margalit, Ronit
description IntroductionScarce 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.MethodsWe 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.ResultsDuring 868 079 years of follow up (median follow-up: 49.0 years), 3337 women died. Women with IBIs
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We aimed to assess whether IBIs were associated with all-cause, CVD-related and cancer-related mortality.MethodsWe 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.ResultsDuring 868 079 years of follow up (median follow-up: 49.0 years), 3337 women died. Women with IBIs &lt;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 &lt;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.ConclusionOur results support the WHO recommendations for IPIs of ≥24 months and add additional evidence regarding long-term CVD mortality.</description><identifier>ISSN: 0143-005X</identifier><identifier>EISSN: 1470-2738</identifier><identifier>DOI: 10.1136/jech-2020-214242</identifier><identifier>PMID: 32655002</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Age ; Births ; Cancer ; Cardiovascular diseases ; Cohort analysis ; Education ; EPIDEMIOLOGY ; Lifecourse/ Childhood Circumstances ; Maternal &amp; child health ; MATERNAL HEALTH ; Maternal mortality ; Menstruation ; MIDWIFERY ; Mortality ; Original research ; Parent educational background ; Population ; Population studies ; Population-based studies ; Preeclampsia ; Pregnancy ; SOCIAL INEQUALITIES ; Socioeconomic factors ; Socioeconomics ; Variables ; Variance analysis ; Womens health</subject><ispartof>Journal of epidemiology and community health (1979), 2020-11, Vol.74 (11), p.957-963</ispartof><rights>Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2020 Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b400t-e6db0d89df3a61bb27cecf5f19945eae4a938e4343551ca43400de33d782308b3</citedby><cites>FETCH-LOGICAL-b400t-e6db0d89df3a61bb27cecf5f19945eae4a938e4343551ca43400de33d782308b3</cites><orcidid>0000-0002-5064-5902</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jech.bmj.com/content/74/11/957.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://jech.bmj.com/content/74/11/957.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>112,113,314,776,780,3180,27903,27904,55319,77340,77341,77342,77343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32655002$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weisband, Yiska Loewenberg</creatorcontrib><creatorcontrib>Manor, Orly</creatorcontrib><creatorcontrib>Friedlander, Yechiel</creatorcontrib><creatorcontrib>Hochner, Hagit</creatorcontrib><creatorcontrib>Paltiel, Ora</creatorcontrib><creatorcontrib>Calderon-Margalit, Ronit</creatorcontrib><title>Interpregnancy and interbirth intervals and all-cause, cardiovascular-related and cancer-related maternal mortality: findings from a large population-based cohort study</title><title>Journal of epidemiology and community health (1979)</title><addtitle>J Epidemiol Community Health</addtitle><addtitle>J Epidemiol Community Health</addtitle><description>IntroductionScarce 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.MethodsWe 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.ResultsDuring 868 079 years of follow up (median follow-up: 49.0 years), 3337 women died. Women with IBIs &lt;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 &lt;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. 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We aimed to assess whether IBIs were associated with all-cause, CVD-related and cancer-related mortality.MethodsWe 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.ResultsDuring 868 079 years of follow up (median follow-up: 49.0 years), 3337 women died. Women with IBIs &lt;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 &lt;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.ConclusionOur results support the WHO recommendations for IPIs of ≥24 months and add additional evidence regarding long-term CVD mortality.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd</pub><pmid>32655002</pmid><doi>10.1136/jech-2020-214242</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-5064-5902</orcidid></addata></record>
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source BMJ Publishing; JSTOR Archival Journals
subjects Age
Births
Cancer
Cardiovascular diseases
Cohort analysis
Education
EPIDEMIOLOGY
Lifecourse/ Childhood Circumstances
Maternal & child health
MATERNAL HEALTH
Maternal mortality
Menstruation
MIDWIFERY
Mortality
Original research
Parent educational background
Population
Population studies
Population-based studies
Preeclampsia
Pregnancy
SOCIAL INEQUALITIES
Socioeconomic factors
Socioeconomics
Variables
Variance analysis
Womens health
title Interpregnancy and interbirth intervals and all-cause, cardiovascular-related and cancer-related maternal mortality: findings from a large population-based cohort study
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