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      Evaluation the Association between Labor Dystocia and Birth Spacing in Iranian Women

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          Abstract

          Objective: In view of the effect of hard labor on pregnancy outcomes and to determine risk factors, in this study, the effect of spacing between pregnancies was evaluated for probable effect on the incidence of dystocia in labor.

          Materials and methods: This is a cross - sectional study used the records of 210 pregnant women referred to Azad University hospitals between January 2000 and December 2012. Dystocia was diagnosed according to ICD-9-CM. Data were analyzed using statistical software Spss 17.

          Results: It was found that in pregnancies with 2-4 years spacing between births normal delivery was more prevalent while in the group with 8-10 years spacing labor dystocia was more prevalent.

          Conclusion: Based on the findings of this study the interval between pregnancies has a significant effect on labor dystocia. Increasing the spacing between pregnancies more than 8 years is a risk factor for dystocia.

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          Effects of interpregnancy interval and outcome of the preceding pregnancy on pregnancy outcomes in Matlab, Bangladesh

          J DaVanzo, Iago Hale, A Razzaque … (2007)
          Objective To estimate the effects on pregnancy outcomes of the duration of the preceding interpregnancy interval (IPI) and type of pregnancy outcome that began the interval. Design Observational population-based study. Setting The Maternal Child Health–Family Planning (MCH–FP) area of Matlab, Bangladesh. Population A total of 66 759 pregnancy outcomes that occurred between 1982 and 2002. Methods Bivariate tabulations and multinomial logistic regression analysis. Main outcome measures Pregnancy outcomes (live birth, stillbirth, miscarriage [spontaneous fetal loss prior to 28 weeks], and induced abortion). Results When socio-economic and demographic covariates are controlled, of the IPIs that began with a live birth, those <6 months in duration were associated with a 7.5-fold increase in the odds of an induced abortion (95% CI 6.0–9.4), a 3.3-fold increase in the odds of a miscarriage (95% CI 2.8–3.9), and a 1.6-fold increase in the odds of a stillbirth (95% CI 1.2–2.1) compared with 27- to 50-month IPIs. IPIs of 6–14 months were associated with increased odds of induced abortion (2.0, 95% CI 1.5–2.6). IPIs ≥ 75 months were associated with increased odds of all three types of non-live-birth (NLB) outcomes but were not as risky as very short intervals. IPIs that began with a NLB were generally more likely to end with the same type of NLB. Conclusions Women whose pregnancies are between 15 and 75 months after a preceding pregnancy outcome (regardless of its type) have a lower likelihood of fetal loss than those with shorter or longer IPIs. Those with a preceding NLB outcome deserve special attention in counselling and monitoring. Please cite this paper as: DaVanzo J, Hale L, Razzaque A, Rahman M. Effects of interpregnancy interval and outcome of the preceding pregnancy on pregnancy outcomes in Matlab, Bangladesh. BJOG 2007;114:1079–1087.
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            Interpregnancy interval and obstetrical complications.

            Deirdre J Lyell, Bat Shachar (2012)
            Obstetricians are often presented with questions regarding the optimal interpregnancy interval (IPI). Short IPI has been associated with adverse perinatal and maternal outcomes, ranging from preterm birth and low birth weight to neonatal and maternal morbidity and mortality. Long IPI has in turn been associated with increased risk for preeclampsia and labor dystocia. In this review, we discuss the data regarding these associations along with recent studies revealing associations of short IPI with birth defects, schizophrenia, and autism. The optimal IPI may vary for different subgroups. We discuss the consequences of short IPI in women with a prior cesarean section, in particular the increased risk for uterine rupture and the considerations regarding a trial of labor in this subgroup. We review studies examining the interaction between short IPI and advanced maternal age and discuss the risk-benefit assessment for these women. Finally, we turn our attention to women after a stillbirth or an abortion, who often desire to conceive again with minimal delay. We discuss studies speaking in favor of a shorter IPI in this group. The accumulated data allow for the reevaluation of current IPI recommendations and management guidelines for women in general and among subpopulations with special circumstances. In particular, we suggest lowering the current minimal IPI recommendation to only 18 months (vs 24 months according to the latest World Health Organization recommendations), with even shorter recommended minimal IPI for women of advanced age and those who conceive after a spontaneous or induced abortion.
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              Effect of very advanced maternal age on pregnancy outcome and rate of cesarean delivery.

              E Schiff, Andrew D Seidman, S Mashiach … (1998)
              To determine outcomes of pregnancies in women at least 44 years of age and to determine factors predicting cesarean delivery in these patients. Between January 1988 and December 1995, 109 women at least 44 years old delivered in our medical center. These women were matched to a group of 309 women 20-29 years of age. Multiple logistic regression analysis was used to evaluate the association between maternal age and outcome variables, controlling for possible confounding factors. Based on the logistic regression, a predictive model was calculated for cesarean delivery and validated prospectively in a separate group of 30 consecutive women at least 44 years old, who delivered during the first 8 months of 1996. Very advanced maternal age, compared with younger age, was associated with a significantly higher rate of medical complications (hypertensive disorder and diabetes) (odds ratio [OR] 2.5; 95% confidence interval [CI] 1.5, 4.1; P < .001), instrument-assisted vaginal delivery (OR 7.5; 95% CI 2.2, 25.0; P < .004), and cesarean delivery (OR 7.3; 95% CI 2.2, 16.7; P < .001). The incidences of preterm labor, premature rupture of membranes, emergency cesarean delivery, meconium-stained amniotic fluid, small for gestational age newborns, and 5-minute Apgar scores of 7 or lower were not influenced by maternal age. The regression model showed an increased risk for cesarean delivery associated with age of at least 44 years (OR 7.3; 95% CI 2.2, 16.7), primiparity (OR 3.5; 95% CI 1.3, 9.8), infertility treatment (OR 3.6; 95% CI 1.5, 8.8), and egg donation (OR 19.5; 95% CI 6.1, 62.2), with positive and negative predictive values of 94 and 86%, respectively. Maternal age of at least 44 years is associated with medical complications in pregnancy and more interventions during labor. However, overall pregnancy outcomes are favorable. Cesarean delivery can be predicted accurately based on maternal age, parity, and infertility treatment.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Family Reprod Health
                Journal ID (iso-abbrev): J Family Reprod Health
                Journal ID (publisher-id): JFRH
                Title: Journal of Family & Reproductive Health
                Publisher: Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences (Tehran, Iran )
                ISSN (Print): 1735-8949
                ISSN (Electronic): 1735-9392
                Publication date (Print): September 2014
                Volume: 8
                Issue: 3
                Pages: 101-105
                Affiliations
                [1 ]Young Researchers’ Club and Elite, Tehran Medical Branch, Islamic Azad University, Tehran, Iran
                [2 ]Sarem Cell Research Center- SCRC, Sarem Women’s Hospital, Tehran, Iran
                [3 ]Islamic Azad University Research Center, Medical Tehran Branch, Tehran, Iran
                [4 ]Students' Research Committee, Tehran Medical Branch, Islamic Azad University, Tehran, Iran
                [5 ]Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran
                Author notes
                Correspondence: Mina Jafarabadi, Reproductive Health Research Center, Emam Hospital, Keshavarz Blvd., Tehran, 14194, Iran jafarabadi@ 123456tums.ac.ir
                Article
                Publisher ID: JFRH-8-101
                PMC ID: 4275550
                SO-VID: f0f67a73-ece4-443d-9b11-62091cf0b28a
                Copyright © Copyright © Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : January 2014
                Date accepted : April 2014
                Categories
                Subject: Original Article

                Keywords: labor dystocia,inter-pregnancy interval,difficult childbirth
                Data availability:
                Keywords: labor dystocia, inter-pregnancy interval, difficult childbirth

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