Report of the Office of Population Affairs Expert Work Group Meeting on Short Birth Spacing and Adverse Pregnancy Outcomes: Methodological quality of existing studies and future directions for research

Katherine A. Ahrens PhD, University of Southern Maine, Muskie School of Public ServiceFollow
Jennifer A. Hutcheon, University of British Columbia, Department of Obstetrics and Gynaecology
Cande V. Anath, Columbia University, Vagelos College of Physicians and Surgeons
Olga Basso, McGill University, Research Institute of McGill University Health Centre
Peter A. Briss, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
Cynthia D. Ferré, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
Brittni N. Frederiksen, U.S. Department of Health and Human Services, Office of Population Affairs
Sam Harper, McGill University, Biostatistics and Occupational Health
Sonia Hernández-Díaz DrPH, Harvard University, Harvard T. H. Chan School of Public Health
Ashley H. Hirai, US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau
Russell S. Kirby, University of South Florida College of Public Health
Mark A. Klebanoff, The Ohio State University, The Research Institute at Nationwide Children's Hospital
Laura Lindberg, Guttmacher Institute
Sunni L. Mumford, National Institute of Child Health and Human Development
Heidi D. Nelson, Oregon Health & Science University, Department of Medical Informatics and Clinical Epidemiology
Robert W. Platt, McGill University, Biostatistics and Occupational Health
Laura M. Rossen, Centers for Disease Control and Prevention, National Center for Health Statistics
Alison M. Stuebe, University of North Carolina at Chapel Hill University of North Carolina School of Medicine
Marie E. Thoma, University of Maryland at College Park, Department of Family Science
Catherine J. Vladitiu, US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau
Susan Moskosky, U.S. Health and Human Services, Office of Population Affairs

Document Type

Article

Publication Date

10-2018

Publication Title

Paediatric and Perinatal Epidemiology

Keywords

birth spacing, confounding, contraception, interpregnancy interval, maternal health, neonatal health, preterm birth, study design

Abstract

Background: The World Health Organization (WHO) recommends that women wait at least 24 months after a livebirth before attempting a subsequent pregnancy to reduce the risk of adverse maternal, perinatal, and infant health outcomes. However, the applicability of the WHO recommendations for women in the United States is unclear, as breast feeding, nutrition, maternal age at first birth, and total fertility rate differs substantially between the United States and the low- and middle-resource countries upon which most of the evidence is based.

Methods: To inform guideline development for birth spacing specific to women in the United States, the Office of Population Affairs (OPA) convened an expert work group meeting in Washington, DC, on 14-15 September 2017 among reproductive, perinatal, paediatric, social, and public health epidemiologists; obstetrician-gynaecologists; biostatisticians; and experts in evidence synthesis related to women's health.

Results: Presentations and discussion topics included the methodological quality of existing studies, evaluation of the evidence for causal effects of short interpregnancy intervals on adverse perinatal and maternal health outcomes, good practices for future research, and identification of research gaps and priorities for future work.

Conclusions: This report provides an overview of the presentations, discussions, and conclusions from the expert work group meeting.

Comments

This product was supported, in part, by a contract between the Office of Population Affairs and Atlas Research, LLC [# HHSP233201450040A]. SLM was supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.

Conflict of Interest: Peter Briss, Lauren Rossen, and Cynthia Ferré work for the Centers for Disease Control and Prevention, an agency that published the Providing Quality Family Planning Services Recommendations with the Office of Population Affairs in 2014. Mark Klebanoff noted that his participation in the meeting was not intended to disqualify researchers working at The Ohio State University from responding to future requests for proposals from the Office of Population Affairs.

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