Post-partum interval and time to pregnancy in a prospective preconception cohort.
fecundability
interpregnancy interval
post-partum interval
prospective cohort
time to pregnancy
Journal
Paediatric and perinatal epidemiology
ISSN: 1365-3016
Titre abrégé: Paediatr Perinat Epidemiol
Pays: England
ID NLM: 8709766
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
revised:
09
04
2020
received:
05
12
2019
accepted:
03
05
2020
pubmed:
24
7
2020
medline:
25
11
2021
entrez:
24
7
2020
Statut:
ppublish
Résumé
Little is known about the influence of the post-partum interval-defined as the time between giving birth and attempting to conceive again-on subsequent fecundability. We evaluated the association between the post-partum interval and fecundability in Pregnancy Study Online (PRESTO), a web-based prospective preconception cohort of pregnancy planners from the United States and Canada. Eligible women were aged 21-45 years, attempting pregnancy, and not using fertility treatment. Women completed a baseline questionnaire to ascertain information on demographics, life style factors, and reproductive history, including detailed information on all previous pregnancies. They completed bi-monthly follow-up questionnaires for up to 12 months to update pregnancy status over time. We used proportional probabilities regression models to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs) adjusted for sociodemographic and reproductive history covariates. Analyses were restricted to multiparous women who had been attempting pregnancy with the same male partner for ≤6 menstrual cycles at enrolment. During 2013-2019, 1489 female participants contributed 959 pregnancies and 5003 cycles. The median post-partum interval was 18 months. Compared with a 12- to 23-month post-partum interval, FRs for post-partum intervals of <12, 24-47, and ≥48 months were 0.89 (95% CI 0.77, 1.04), 1.06 (95% CI 0.91, 1.23), and 0.81 (95% CI 0.62, 1.05), respectively. When restricting to women without a history of subfertility, results were consistent for long post-partum interval and attenuated for short post-partum interval. Among North American pregnancy planners, long post-partum intervals (≥48 months) were associated with slightly reduced fecundability. Short post-partum intervals (<12 months) were weakly associated with reduced fecundability in some subgroups including women with a history of caesarean delivery and planned pregnancies.
Sections du résumé
BACKGROUND
Little is known about the influence of the post-partum interval-defined as the time between giving birth and attempting to conceive again-on subsequent fecundability.
OBJECTIVES
We evaluated the association between the post-partum interval and fecundability in Pregnancy Study Online (PRESTO), a web-based prospective preconception cohort of pregnancy planners from the United States and Canada.
METHODS
Eligible women were aged 21-45 years, attempting pregnancy, and not using fertility treatment. Women completed a baseline questionnaire to ascertain information on demographics, life style factors, and reproductive history, including detailed information on all previous pregnancies. They completed bi-monthly follow-up questionnaires for up to 12 months to update pregnancy status over time. We used proportional probabilities regression models to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs) adjusted for sociodemographic and reproductive history covariates. Analyses were restricted to multiparous women who had been attempting pregnancy with the same male partner for ≤6 menstrual cycles at enrolment.
RESULTS
During 2013-2019, 1489 female participants contributed 959 pregnancies and 5003 cycles. The median post-partum interval was 18 months. Compared with a 12- to 23-month post-partum interval, FRs for post-partum intervals of <12, 24-47, and ≥48 months were 0.89 (95% CI 0.77, 1.04), 1.06 (95% CI 0.91, 1.23), and 0.81 (95% CI 0.62, 1.05), respectively. When restricting to women without a history of subfertility, results were consistent for long post-partum interval and attenuated for short post-partum interval.
CONCLUSIONS
Among North American pregnancy planners, long post-partum intervals (≥48 months) were associated with slightly reduced fecundability. Short post-partum intervals (<12 months) were weakly associated with reduced fecundability in some subgroups including women with a history of caesarean delivery and planned pregnancies.
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
271-280Subventions
Organisme : Eunice Kennedy Shriver National Institute of Child Health and Human Development
ID : R01-HD086742
Organisme : Eunice Kennedy Shriver National Institute of Child Health and Human Development
ID : R21-HD072326
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 John Wiley & Sons Ltd.
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