Short birth/pregnancy interval and its association with adverse maternal outcomes in Asia Pacific region: A systematic review and meta-analysis

Abstract

Background

Short interpregnancy/birth interval (SIBI) may be associated with greater risks of adverse pregnancy outcomes. This study aimed to synthesise the literature on the association between SIBI and adverse maternal outcomes in Asia-Pacific.

Methods

Five databases were searched for studies published between 2000 and 2023. Studies were eligible if they reported an association between SIBI and adverse maternal outcomes (e.g., anaemia). Studies that met the WHO's definition of SIBI were included in the meta-analysis. The key findings were then summarised through qualitative synthesis and meta-analyses.

Results

26 articles that examined the association between SIBI and adverse maternal outcomes and were included in the narrative synthesis. Eight studies examined anaemia, two examined antenatal or postnatal depression, three assessed gestational diabetes mellitus, and four studies examined preeclampsia. A significant association between SIBI and anaemia was reported, indicating an 181 % increase in anaemia with a SIBI (OR of 2.81;95 % CI: 1.30–4.31) compared to an optimal birth interval. There was a significant association between SIBI and gestational diabetes mellitus (OR of 0.68; 95 % CI: 0.65–0.71), antenatal or postnatal depression (OR of 2.36; 95 % CI: 1.76, 3.01) but no significant associations were found for preeclampsia (OR of 0.74; 95 % CI: 0.48–1.01).

Conclusion

Our review highlights that SIBI places women at an increased risk of adverse maternal outcomes compared to optimal birth interval. This indicates the importance of addressing short birth interval through effective contraception as a key maternal health intervention to reduce adverse maternal outcomes.