Effect of interpregnancy interval on adverse pregnancy outcomes in northern Tanzania: A registry-based retrospective cohort study

Background: Both short and long interpregnancy intervals have been associated with an increased risk of adverse pregnancy outcomes. There is limited information about the impact of interpregnancy interval on pregnancy (IPI) outcomes in Tanzania. The objective of this study was to assess the effect of IPI on adverse pregnancy outcomes. Methods: We performed a retrospective cohort study using maternally-linked data from Kilimanjaro Christian Medical Centre (KCMC) birth registry. A total of 17,030 singlet births from women who delivered singleton infant at KCMC from 2000 to 2010 were studied. Women with multi-fetal gestations and those who were referred from rural areas for various medical reasons were excluded. Outcome variables were preterm birth, low birth weight infants and perinatal death. A multiple logistic regression was used to assess the association between IPI and pregnancy outcomes. Results: The median IPI was 36 months. Compared with IPIs of 24-36 months (referent group), short interpregnancy intervals (<24 months) was associated with preterm delivery (OR 1.52; 95 % CI 1.31-1.74); low birth weight (OR 1.61; 95 % CI 1.34-1.72) and perinatal death, (OR 1.63; 95 % CI 1.22-1.91). The IPI of 37-59 months or longer were also associated with higher risks of preterm birth and low birth weight, but not with perinatal death. Conclusions: Our study confirmed that both short and long IPI are independent risk factors for adverse pregnancy outcomes. These finding emphasize the importance of providing support for family planning programs which will support optimal IPI and improve pregnancy outcomes.