METHODS: A comprehensive search of five databases was conducted targeting studies published between 2000 to 2023. Studies that reported on short inter-pregnancy or birth interval and examined adverse perinatal outcomes, such as low birthweight (LBW) preterm birth (PTB), small for gestational age (SGA), and neonatal mortality were included and appraised for methodological quality using the Joanna Briggs Institute critical appraisal tools. Three reviewers independently screened the studies and performed data extraction. Narrative synthesis and meta-analyses were conducted to summarise the key findings.
RESULTS: A total of 41 studies that fulfilled the inclusion criteria were included. A short-interpregnancy interval was associated with an increased risk of low birthweight (odds ratio [OR] = 1.65; 95%CI:1.39, 1.95), preterm birth (OR = 1.50; 95%CI: 1.35, 1.66), and small for gestational age (OR = 1.24; 95%CI:1.09, 1.41). We also found elevated odds of early neonatal mortality (OR = 1.91; 95%CI: 1.11, 3.29) and neonatal mortality (OR = 1.78; 95%CI: 1.25, 2.55) among women with short birth intervals.
CONCLUSIONS: This review indicates that both short inter-pregnancy and birth interval increased the risk of adverse perinatal outcomes. This underscores the importance of advocating for and implementing strategies to promote optimal pregnancy and birth spacing to reduce the occurrence of adverse perinatal outcomes. Reproductive health policies and programs need to be further strengthened and promote access to comprehensive family planning services and increase awareness about the importance of optimal pregnancy and birth spacing.
方法:针对2000年至2023年发表的研究,对五个数据库进行了全面搜索。研究报告了短的妊娠间期或出生间隔,并检查了不良的围产期结局,例如低出生体重(LBW)早产(PTB),小于胎龄(SGA),和新生儿死亡率被包括在内,并使用JoannaBriggs研究所关键评估工具评估方法学质量。三名评审员独立筛选研究并进行数据提取。进行了叙事综合和荟萃分析以总结关键发现。
结果:共纳入41项符合纳入标准的研究。妊娠间隔时间短与低出生体重风险增加相关(比值比[OR]=1.65;95CI:1.39,1.95),早产(OR=1.50;95CI:1.35,1.66),小于胎龄(OR=1.24;95CI:1.09,1.41)。我们还发现出生间隔短的女性中早期新生儿死亡率(OR=1.91;95CI:1.11,3.29)和新生儿死亡率(OR=1.78;95CI:1.25,2.55)的几率升高。
结论:本综述表明,短的妊娠间期和出生间隔增加了不良围产期结局的风险。这强调了倡导和实施促进最佳怀孕和生育间隔以减少不良围产期结局发生的战略的重要性。需要进一步加强生殖健康政策和方案,促进获得全面的计划生育服务,并提高对最佳怀孕和生育间隔重要性的认识。