Stillbirth or Neonatal Death, Pregnancy Intention and Short Inter-Pregnancy Interval among Women following Early Preterm Birth

Heather Forquer, University of Pennsylvania
Ian Bennett, University of Pennsylvania
David Webb, Children's Hospital of Philadelphia
Jennifer Culhane, Drexel University

Data from the Philadelphia Collaborative Preterm Prevention Project (PCPPP) - an RCT evaluating the efficacy of inter-pregnancy interventions to reduce repeat preterm births – were analyzed to assess the relationships between stillbirth or neonatal death of the preterm infant and the subsequent inter-pregnancy intervals of mothers enrolled in the study. Women with stillbirth or neonatal death had approximately 3.1 times higher odds of short inter-pregnancy interval (<18 months) compared to women without such a loss (aOR=3.09, 95% 1.88-5.11). This elevated odds of short inter-pregnancy interval was independent of pregnancy intention. These findings can inform efforts to improve the advice provided to women already at risk for a (repeat) preterm delivery – risk which may in fact be further elevated because of the desire, driven by the complicated emotions surrounding the loss of an infant, to become pregnant again too soon.