短期和长期妊娠间隔对新生儿结局的影响：多分类队列分析
Impact of Short and Long Interpregnancy Intervals on Neonatal Outcomes: A Multiclassification Cohort Analysis.
摘要(中文译文)
背景：妊娠间隔（IPI）对新生儿健康起着关键作用，然而最佳间隔时间仍存在争议。本研究采用三种互补的分类方法评估短妊娠间隔和长妊娠间隔的新生儿结局，以识别一致的风险模式。方法：在这项回顾性队列研究中，分析了2024年在一家三级转诊中心分娩单胎妊娠且有既往活产史的1194名女性的病历资料。妊娠间隔按分娩至受孕间隔计算（末次月经+14天）。应用了三种妊娠间隔分类系统：（1）经典截断值（<6、6-11、12-23、24-59和≥60个月），（2）四分位数，以及（3）三分位数。主要结局包括早产、低出生体重（LBW）和新生儿重症监护病房（NICU）入住。多因素logistic回归模型对产妇年龄、孕次和既往剖宫产进行了校正。结果：短妊娠间隔（6-11个月）的NICU入住率最高（29.4%）。极长妊娠间隔（≥60个月）的低出生体重患病率最高（16.6%）。多因素回归分析显示，间隔≥24个月是早产的独立保护因素（24-59个月：aOR 0.48，P=0.002；≥60个月：aOR 0.58，P=0.042），而产妇年龄使早产风险每年增加7%。短妊娠间隔（6-11个月）和极长妊娠间隔（≥60个月）分别独立增加NICU入住风险（aOR 2.29，P=0.002和aOR 1.61，P=0.036）。既往剖宫产是NICU入住的独立预测因素（aOR 1.35；P=0.048）。结论：短妊娠间隔和极长妊娠间隔与新生儿发病率增加相关，尤其是NICU入住，而长间隔中明显的早产风险在很大程度上由产妇年龄介导。经校正后，超过24个月的妊娠间隔对早产表现出保护作用。然而，间隔超过5年时低出生体重和NICU入住呈上升趋势，提示以18-24个月为最佳窗口的生育间隔咨询能够在最小化相互竞争的新生儿风险方面提供最佳平衡。
Abstract
Interpregnancy interval (IPI) plays a critical role in neonatal health, yet optimal spacing remains controversial. This study assessed neonatal outcomes across short and long IPI using three complementary classification approaches to identify consistent patterns of risk. In this retrospective cohort study, medical records of 1194 women with a prior live birth who delivered singleton pregnancies in 2024 at a tertiary referral center were analyzed. IPI was calculated as the delivery-to-conception interval (LMP + 14 days). Three IPI classification systems were applied: (1) classical cut-offs (<6, 6-11, 12-23, 24-59, and ≥60 months), (2) quartiles, and (3) tertiles. Primary outcomes included preterm birth, low birth weight (LBW), and NICU admission. Multivariable logistic regression models adjusted for maternal age, gravidity, and previous cesarean delivery. Short IPI (6-11 months) demonstrated the highest NICU admission rates (29.4%). Very long IPI (≥60 months) showed the highest prevalence of LBW (16.6%). Multivariable regression analysis revealed that intervals ≥ 24 months were independently protective against preterm birth (24-59 months: aOR 0.48, = 0.002; ≥60 months: aOR 0.58, = 0.042), while maternal age increased preterm birth risk by 7% per year. Short IPI (6-11 months) and very long IPI (≥60 months) independently increased NICU admission risk (aOR 2.29, = 0.002 and aOR 1.61, = 0.036, respectively). Previous cesarean delivery was an independent predictor of NICU admission (aOR 1.35; = 0.048). Short and very long IPIs are associated with increased neonatal morbidity, particularly NICU admission, while the apparent preterm risk in long intervals is largely mediated by maternal age. Once adjusted, IPIs exceeding 24 months demonstrate protective effects against preterm birth. However, the rising trend toward LBW and NICU admission in intervals beyond 5 years suggests that birth-spacing counseling targeting an optimal window of 18-24 months provides the best balance in minimizing competing neonatal risks.
如何引用
AMA
Gizem Boz Izceyhan, Resul Karakuş, Mina Erbıyık. Impact of Short and Long Interpregnancy Intervals on Neonatal Outcomes: A Multiclassification Cohort Analysis.. Healthcare (Basel, Switzerland). 2026; doi:10.3390/healthcare14070826.
APA
Gizem Boz Izceyhan, Resul Karakuş, Mina Erbıyık (2026). Impact of Short and Long Interpregnancy Intervals on Neonatal Outcomes: A Multiclassification Cohort Analysis.. Healthcare (Basel, Switzerland). https://doi.org/10.3390/healthcare14070826
GB/T 7714
Gizem Boz Izceyhan, Resul Karakuş, Mina Erbıyık. Impact of Short and Long Interpregnancy Intervals on Neonatal Outcomes: A Multiclassification Cohort Analysis.[J]. Healthcare (Basel, Switzerland), 2026 doi:10.3390/healthcare14070826.
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