Perinatal & Pediatric
Determinants of short interpregnancy intervals Jennifer Dunne* Jennifer Dunne Gizachew Tessema Gavin Pereira
Introduction
Interpregnancy interval (IPI) is defined as the time between birth and commencement of the next pregnancy. Short IPI (<6-18 months) is a modifiable risk factor for adverse maternal, perinatal, and child health outcomes. Relatively little research has been undertaken to determine the factors that influence IPIs in high-income countries. This study investigated individual, relationship, community and societal factors that influenced IPIs in high-income countries.
Methods
A systematic search was undertaken in CINAHL Plus, Ovid/EMBASE, Ovid/MEDLINE, Ovid/PsycINFO, ProQuest, PubMed, Scopus, Web of Science, and Google Scholar for articles published in English from January 1st 1990 to October 17th 2023. Studies were included if they reported an effect estimate for at least one determinant of birth spacing. The socioecological model was used as a guiding framework to systematically examine multilevel risk and protective factors of IPIs.
Results
Of the 264 unique articles identified for full text review, 53 met the inclusion criteria for the final systematic review. Four levels of risk and protective factors related to short IPI were identified (individual, relationship, community, societal). The majority of the included studies reported influencing factors at the individual level (n=43), with maternal age, ethnicity, education, contraception use, and parity deemed risk factors. At the relationship level, peer influence and familial characteristics were risk factors of short IPIs. Access to health care services were a protective factor for short IPIs at the community level, with social insurance provision at the societal level the most influential factor on short IPIs.
Conclusion
Multi-dimensional factors influence short IPIs in high income countries. The outcomes of this study will inform prenatal and postpartum counselling programs, and the development of targeted educational programs, to improve optimum IPIs.