Review
Effect of the interval between pregnancies on the health of mother and child

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Introduction

The interpregnancy interval is the time between the end of one pregnancy and the beginning of another. It is usually measured by determining the delivery dates of consecutive pregnancies and subtracting the gestational age of the most recent. It can also be defined as the time between the termination of one pregnancy and the last menstrual period before the next one. Some studies use an interbirth interval, i.e. the time between two consecutive deliveries. A third measure is the interconception interval, i.e. the time between conceptions [1], [2], [3].

In reviewing studies of the possible effect of birth spacing, it is important to consider which measurement was used. Measures that depend on knowing the date of conception are less likely to be accurate than those that depend on the date of delivery, and pre-term deliveries have different effect on each of these measures [3].

Section snippets

What is the natural interpregnancy interval?

Resumption of ovulation may occur as soon as 27 days after delivery for well-nourished non-breastfeeding women but may be delayed several years among mothers whose infants are exclusively breastfed.

Infants conceived 18–23 months after a previous live birth have the lowest risk of adverse perinatal outcomes. These associations persist when the data are adjusted for other risk factors, and there is a J-shaped association between interpregnancy interval and risk of low-birth-weight.

Adverse effects of short interpregnancy intervals on the health of child and mother

Several studies have found that short intervals between the birth of one child and conception of the next are associated with an elevated risk of low-birth-weight [1], [4], [5], [6], [7], [8]. The risk is particularly high when the firstborn child had succumbed to sudden infant death syndrome (SIDS) [9]; fewer have found an association with pre-term birth [10], [11]; and even fewer with infant deaths [3].

Short interpregnancy interval may also represent a significant risk for the development of

Adverse effects of long interpregnancy intervals on the health of child and mother

Longer than average interpregnancy intervals may also cause problems but apparent adverse effects may result from other causes. Women conceiving after a long pregnancy interval may be elderly or subfertile or it may be an unplanned pregnancy. All these factors would increase the risk of adverse outcomes [3] and may also significantly increase the risk of developing pre-eclampsia and eclampsia [14].

Zhu et al. attempted to determine the optimal interpregnancy interval [4]. They studied the birth

What are the perspectives?

While more studies of the economic and social, as well as the physiological effects of pregnancy intervals on mothers, their children, and their families are undoubtedly required, there is some consensus about the optimal interval between pregnancies. Women who plan to become pregnant less than six or more than 120 months after a previous pregnancy can be reassured, only in case of absence of other risk factors, that the risk is likely to be less than the data of Zhu et al. [4] would indicate

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