(SDAS) A Population-Based Secondary Data Analysis of Short Birth Intervals: Adverse Pregnancy Outcomes, Pregnancy Intention, and Postpartum Contraceptive Use
Grantee: University of North Carolina at Charlotte
Principal Investigator: Larissa B Huber
Project Number: R40MC29446
Project Date: 04/01/2016
Age group(s)
- Women/Maternal
Targeted/Underserved Population
- African American
- Hispanic/Latino
Abstract
In the US, approximately 33% of pregnancies are conceived within 18 months of a previous pregnancy. Pregnancies that result from these short birth intervals (SBI) can pose serious risks for the mother and infant. Although studies have investigated the association between SBI and adverse pregnancy outcomes such as preterm birth and low birth weight, literature on outcomes such as premature rupture of membranes (PROM), placenta previa, and gestational diabetes is sparse, and findings related to small for gestational age (SGA) have been inconsistent. Information on factors associated with pregnancy intention or postpartum contraceptive use among women who have experienced SBI also is limited. The objective of the proposed research is to address these gaps through analyses of existing data. To achieve this objective, the following aims are proposed: 1) to determine the association between SBI and understudied adverse pregnancy outcomes including SGA, PROM, placenta previa, and gestational diabetes; 2) to assess the relationships of selected demographic, lifestyle, and reproductive factors with pregnancy intention among women who experienced SBI; and 3) to evaluate factors associated with postpartum contraceptive use among women with SBI. Data from the Pregnancy Risk Assessment and Monitoring System (PRAMS), a large national survey that collects population-based information on maternal experiences before, during, and after pregnancy from women who have recently had a live birth, will be used. Women who participate in PRAMS receive a self-administered survey in the mail, and responses are linked to birth certificate data for analysis by CDC personnel. Since only Mississippi and Tennessee include a question about SBI on their PRAMS survey, this secondary data analysis is limited to women aged 18-40 years from those states. Women self-reported information on SBI, placenta previa, gestational diabetes, pregnancy intention, and postpartum contraceptive use. SGA and PROM data are obtained from birth certificates. For Aim 1, multivariate logistic regression will be used to calculate odds ratios and 95% confidence intervals to model the association between SBI and the adverse pregnancy outcomes. Similar analytic methods will be used for Aims 2 and 3. Unlike previous studies of the SBI-adverse pregnancy outcomes association, this study will use birth certificate data in combination with survey data, which will allow for better control of confounding. In addition, this study will be unique in that factors associated with pregnancy intention and postpartum contraceptive use will be assessed among women who have experienced SBI. Findings from this study will be directly related to the Healthy People 2020 objective to reduce the proportion of pregnancies conceived within 18 months of a previous pregnancy. In addition, the proposed research aligns with Maternal and Child Health Bureau Strategic Research Issue #IV: Promoting the healthy development of maternal and child health populations. The potential public health impact of the proposed research is substantial. Study findings may provide additional evidence of the benefits of women spacing their pregnancies appropriately and may support the value of providing family planning services so that closely spaced pregnancies and unintended pregnancies can be avoided.Publications
Listed is descending order by year published.
Brunner Huber LR, Smith K, Sha W, Vick T. Interbirth interval and pregnancy complications and outcomes: findings from the Pregnancy Risk Assessment Monitoring System. Journal of Midwifery & Women's Health, volume 63, issue 4, pp 436-445
Brunner Huber, LR, Smith K, Sha W, Zhao L, Vick T. Factors associated with pregnancy intention among women who have experienced a short birth interval: findings from the 2009 to 2011 Mississippi and 2009 Tennessee Pregnancy Risk Assessment Monitoring System. Annals of Epidemiology. Volume 28, Issue 6, June 2018. pp 372-376.
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