05 de maio de 2006 (Bibliomed).
Intervalos entre as gestações, curtos ou longos, foram associados com um risco aumentado de problemas gestacionais e problemas no parto do segundo bebê. Isso é o que indicam os resultados de um estudo publicado na última semana na revista JAMA – Journal of the American Medical Association.
Porém, não se sabe se esta possível associação ocorre devido a características maternas ou ao estado socioeconômico da paciente. Pesquisadores colombianos, autores do trabalho, realizaram levantamento de estudos publicados em várias bases de dados médicas relativos ao assunto, desde a década de 1960.
Os investigadores analisaram os resultados de 67 estudos anteriores, envolvendo mais de 11 milhões de mulheres. Os resultados foram ajustados para a idade materna e nível sócio-econômico.
Os resultados indicaram que um intervalo entre as gravidezes, inferior a 18 meses ou superior a 59 meses, aumentou o risco para o segundo filho. Os dados obtidos sugeriram que o espaçamento adequado entre as gestações poderia ajudar a prevenir tais efeitos adversos perinatais.
Fonte: JAMA - Journal of the American Medical Association 2006;295:1809-1823.
http://boasaude.uol.com.br/news/index.cfm?news_id=6309&mode=browse
Vol. 295 No. 15, April 19, 2006
Birth Spacing and Risk of Adverse Perinatal Outcomes
A Meta-analysis
Agustin Conde-Agudelo, MD, MPH; Anyeli Rosas-Bermúdez, MPH; Ana Cecilia Kafury-Goeta, MD
http://boasaude.uol.com.br/news/index.cfm?news_id=6309&mode=browse
Vol. 295 No. 15, April 19, 2006
Birth Spacing and Risk of Adverse Perinatal Outcomes
A Meta-analysis
Agustin Conde-Agudelo, MD, MPH; Anyeli Rosas-Bermúdez, MPH; Ana Cecilia Kafury-Goeta, MD
JAMA. 2006;295:1809-1823.
Context Both short and long interpregnancy intervals have been associated with an increased risk of adverse perinatal outcomes. However, whether this possible association is confounded by maternal characteristics or socioeconomic status is uncertain.
Objective To examine the association between birth spacing and relative risk of adverse perinatal outcomes.
Data Sources Studies published in any language were retrieved by searching MEDLINE (1966 through January 2006), EMBASE, ECLA, POPLINE, CINAHL, and LILACS, proceedings of meetings on birth spacing, and bibliographies of retrieved articles, and by contact with relevant researchers in the field.
Study Selection Included studies were cohort, cross-sectional, and case-control studies with results adjusted for at least maternal age and socioeconomic status, reporting risk estimates and 95% confidence intervals (or data to calculate them) of birth spacing and perinatal outcomes. Of 130 articles identified in the search, 67 (52%) were included.
Data Extraction Information on study design, participant characteristics, measure of birth spacing used, measures of outcome, control for potential confounding factors, and risk estimates was abstracted independently by 2 investigators using a standardized protocol.
Data Synthesis A random-effects model and meta-regression analyses were used to pool data from individual studies. Compared with interpregnancy intervals of 18 to 23 months, interpregnancy intervals shorter than 6 months were associated with increased risks of preterm birth, low birth weight, and small for gestational age (pooled adjusted odds ratios [95% confidence intervals]: 1.40 [1.24-1.58], 1.61 [1.39-1.86], and 1.26 [1.18-1.33], respectively). Intervals of 6 to 17 months and longer than 59 months were also associated with a significantly greater risk for the 3 adverse perinatal outcomes.
Conclusions Interpregnancy intervals shorter than 18 months and longer than 59 months are significantly associated with increased risk of adverse perinatal outcomes. These data suggest that spacing pregnancies appropriately could help prevent such adverse perinatal outcomes.
Context Both short and long interpregnancy intervals have been associated with an increased risk of adverse perinatal outcomes. However, whether this possible association is confounded by maternal characteristics or socioeconomic status is uncertain.
Objective To examine the association between birth spacing and relative risk of adverse perinatal outcomes.
Data Sources Studies published in any language were retrieved by searching MEDLINE (1966 through January 2006), EMBASE, ECLA, POPLINE, CINAHL, and LILACS, proceedings of meetings on birth spacing, and bibliographies of retrieved articles, and by contact with relevant researchers in the field.
Study Selection Included studies were cohort, cross-sectional, and case-control studies with results adjusted for at least maternal age and socioeconomic status, reporting risk estimates and 95% confidence intervals (or data to calculate them) of birth spacing and perinatal outcomes. Of 130 articles identified in the search, 67 (52%) were included.
Data Extraction Information on study design, participant characteristics, measure of birth spacing used, measures of outcome, control for potential confounding factors, and risk estimates was abstracted independently by 2 investigators using a standardized protocol.
Data Synthesis A random-effects model and meta-regression analyses were used to pool data from individual studies. Compared with interpregnancy intervals of 18 to 23 months, interpregnancy intervals shorter than 6 months were associated with increased risks of preterm birth, low birth weight, and small for gestational age (pooled adjusted odds ratios [95% confidence intervals]: 1.40 [1.24-1.58], 1.61 [1.39-1.86], and 1.26 [1.18-1.33], respectively). Intervals of 6 to 17 months and longer than 59 months were also associated with a significantly greater risk for the 3 adverse perinatal outcomes.
Conclusions Interpregnancy intervals shorter than 18 months and longer than 59 months are significantly associated with increased risk of adverse perinatal outcomes. These data suggest that spacing pregnancies appropriately could help prevent such adverse perinatal outcomes.
Author Affiliations: Centro de Estudios e Investigación en Salud and Department of Obstetrics and Gynecology, Fundación Santa Fe de Bogotá, Bogotá, Colombia (Dr Conde-Agudelo); Department of Biostatistics, Universidad Autonoma de Occidente, Cali, Colombia (Ms Rosas-Bermúdez); and Clínica Materno-Infantil Los Farallones, Cali, Colombia (Dr Kafury-Goeta).
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