Study On The Association Of Maternal Age And Interpregnancy Interval With Pregnancy Outcomes

ObjectiveTo analyze the influence of maternal age(MA)and interpregnancy interval(IPI)on pregnancy outcomes,to evaluate the influence of maternal age and interpregnancy interval on pregnancy outcomes and its predictive value using BP neural network.Methods4869 cases of multiparas with singleton pregnancy delivered in Fujian Provincial Maternity and Children’s Hospital from January 1,2017 to December 31,2018.They were divided into two groups: 4195 multiparas in the group of suitable maternal age(20～34)years old,674 multiparas in the group of advanced maternal age(≥35years old).These groups were further divided into 10 periods according to the interpregnancy interval every 12 months: the group of suitable maternal age including153 cases,240 cases,444 cases,501 cases,708 cases,573 cases,498 cases,391 cases,370 cases and 317 cases,the group of advanced maternal age including 24 cases,39 cases,71 cases,81 cases,114 cases,92 cases,80 cases,63 cases,59 cases and 51 cases.Following data of parturient in hospital were collected retrospectively: previous pregnancy: MA,delivery modes,neonatal birth weight(NBW)and sex of the newborn;this pregnancy: education level,BMI,MA,IPI,postpartum hemorrhage(PPH),hypertensive disorders of pregnancy(HDP),gestational diabetes mellitus(GDM),preterm birth(PTB),placental abruption(PA),delivery modes,birth weight(NBW),sex of newborn,macrosomia(MS),small for gestational age(SGA)and asphyxia neonatorum(NA).We will get the best IPI through comparing the differences of pregnancy outcomes with different periods of IPI.In addition,BP neural network was used to evaluate the influence of maternal age and interpregnancy interval on pregnancy outcomes and its predictive value.Results1.The incidence of PPH,HDP,GDM,PA,MS,PTB,SGA in the group of advanced maternal age was significantly higher than that of suitable maternal age(P< 0.05).2.The correlation curves of IPI with PPH,PTB and SGA were all U-shaped in the group of suitable maternal age,the lowest point was near(13～36)months;the correlation curves of IPI with HDP and GDM suggested that when IPI was or less than48 months,the incidence of HDP and GDM was lower,but when IPI was more than 48 months,it increased with the prolongation of IPI;There were significant differences in the incidence of PPH,PTB,SGA,HDP and GDM among the rest of the period(13～24),but there was no significant correlation among IPI with PA,MS and NA.Therefore,with the optimal pregnancy outcomes of the group of suitable maternal age,the optimal IPI is the second to third time period,that is(13～36)months.3.The correlation curves of IPI with PPH,PTB and SGA were all U-shaped in the group of advanced maternal age,and the lowest point was mostly near(13～24)months;The correlation curve among IPI with HDP and GDM indicated that the incidence of HDP and GDM was lower when IPI was or less than 48 months,but higher when IPI more than 48 months;There were significant differences in the incidence of PPH,PTB,SGA,HDP and GDM among the rest of the period(13～24),but there was no significant correlation among IPI with PA,MS and NA.Therefore,with the best pregnancy outcomes in the group of advanced maternal age,the best IPI is the second period,that is(13～24)months.4.BP neural network model was constructed with MA and IPI as input values to analyze their influences on pregnancy outcomes and prediction accuracy,which among PPH,HDP,GDM,PTB,MS and SGA were all more than 85%.Conclusions1.Advanced age is a risk factor for PPH,HDP,GDM,PA,MS,PTB,SGA.2.The duration of IPI will affect the pregnancy outcomes.For the pregnant women with suitable maternal age,the optimal IPI is(13～36)months,for the pregnant women with advanced maternal age,the optimal IPI is(13～24)months.3.BP neural network has certain predictive value for adverse pregnancy outcomes.4.In order to reduce the occurrence of adverse pregnancy outcomes,we should avoid the advanced maternal age and choose the appropriate IPI.5.In the successive pregnancy,BP neural network can be used to evaluate the risk of adverse pregnancy outcomes according to the MA and IPI,and early intervention can be carried out for different pregnancy complications to improve maternal and neonatal outcomes.