Prediction of an estimated delivery date should take into account both the length of a previous pregnancy and the interpregnancy interval

      Abstract

      Objective

      To assess the relationship between gestational lengths of the first and second pregnancies in the same women.

      Study design

      Observational study.

      Methods

      We used information from a dataset of over 500,000 pregnancies from 15 maternity units in the North West Thames, London. Data on the gestational length in days of the first pregnancy and the gestational length in days of the second pregnancy were correlated using regression models. First and second pregnancies were ascribed to the same women by identical maternal date of birth, ethnicity and maternal height (to within ±3 cm).

      Results

      There is a statistically significant cubic relationship between the gestational lengths of the first birth and the second birth (R 0.102, p < 0.001). The gestational length of the second pregnancy is likely to be closer to 280 days than the first pregnancy. In the 20% of women who had an interpregnancy interval of less than one year, the next pregnancy was one day shorter for every three months less than 12.

      Conclusions

      Although the gestation of second pregnancies exhibits regression towards the mean of 280 days, there is still a clinically important tendency for both preterm and postdates pregnancies to recur. Prediction of an estimated delivery date for second pregnancies should take into account both the length of the first pregnancy and the interpregnancy interval if it is less than 12 months.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and Personal
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      References

        • Peek M.J.
        • Devonald K.J.
        • Beilby R.
        • Ellwood D.
        The value of routine early pregnancy ultrasound in the antenatal booking clinic.
        Aust N Z J Obstet Gynaecol. 1994; 34: 140-143
        • Mongelli M.
        • Wilcox M.
        • Gardosi J.
        Estimating the date of confinement: ultrasonographic biometry versus certain menstrual dates.
        Am J Obstet Gynecol. 1996; 174: 278-281
        • Jukic A.M.
        • Baird D.D.
        • Weinberg C.R.
        • McConnaughey D.R.
        • Wilcox A.J.
        Length of human pregnancy and contributors to its natural variation.
        Hum Reprod. 2013; 28: 2848-2855
        • Berkowitz G.S.
        An epidemiologic study of preterm delivery.
        Am J Epidemiol. 1981; 113: 81-92
        • Erkkola R.U.
        • Kero P.O.
        Impact of prematurity on perinatal mortality and morbidity.
        Ann Med. 1991; 23: 663-669
        • Garbaciak Jr., J.A.
        Prematurity prevention: who is at risk?.
        Clin Perinatol. 1992; 19: 275-289
        • Caughey A.B.
        • Bishop J.T.
        Maternal complications of pregnancy increase beyond 40 weeks of gestation in low-risk women.
        J Perinatol. 2006; 26: 540-545
        • Ingemarsson I.
        • Kallen K.
        Stillbirths and rate of neonatal deaths in 76,761 postterm pregnancies in Sweden, 1982–1991: a register study.
        Acta Obstet Gynecol Scand. 1997; 76: 658-662
        • Divon M.Y.
        • Haglund B.
        • Nisell H.
        • Otterblad P.O.
        • Westgren M.
        Fetal and neonatal mortality in the postterm pregnancy: the impact of gestational age and fetal growth restriction.
        Am J Obstet Gynecol. 1998; 178: 726-731
        • Peacock J.L.
        • Bland J.M.
        • Anderson H.R.
        Preterm delivery: effects of socioeconomic factors, psychological stress, smoking, alcohol, and caffeine.
        BMJ. 1995; 311: 531-535
        • Berkowitz G.S.
        • Blackmore-Prince C.
        • Lapinski R.H.
        • Savitz D.A.
        Risk factors for preterm birth subtypes.
        Epidemiology. 1998; 9: 279-285
        • Patel R.
        • Steer P.
        • Doyle P.
        • Little M.
        • Elliot P.
        Does gestation vary by ethnic group? A London-based study of over 122,000 pregnancies with spontaneous onset of labour.
        Int J Epidemiol. 2004; 33: 107-113
        • Caughey A.B.
        • Stotland N.E.
        • Washington A.E.
        • Escobar G.J.
        Who is at risk for prolonged and postterm pregnancy?.
        Am J Obstet Gynecol. 2009; 200 (683 e1–5)
        • Mahande M.J.
        • Daltveit A.K.
        • Obure J.
        • et al.
        Recurrence of preterm birth and perinatal mortality in northern Tanzania: registry-based cohort study.
        Trop Med Int Health. 2013; 18: 962-967
        • Bloom S.L.
        • Yost N.P.
        • McIntire D.D.
        • Leveno K.J.
        Recurrence of preterm birth in singleton and twin pregnancies.
        Obstet Gynecol. 2001; 98: 379-385
        • Ananth C.V.
        • Kirby R.S.
        • Vintzileos A.M.
        Recurrence of preterm birth in twin pregnancies in the presence of a prior singleton preterm birth.
        J Matern Fetal Neonatal Med. 2008; 21: 289-295
        • Schaaf J.M.
        • Hof M.H.
        • Mol B.W.
        • Abu-Hanna A.
        • Ravelli A.C.
        Recurrence risk of preterm birth in subsequent twin pregnancy after preterm singleton delivery.
        BJOG. 2012; 119: 1624-1629
        • Mazaki-Tovi S.
        • Romero R.
        • Kusanovic J.P.
        • et al.
        Recurrent preterm birth.
        Semin Perinatol. 2007; 31: 142-158
        • Zhu B.P.
        • Rolfs R.T.
        • Nangle B.E.
        • Horan J.M.
        Effect of the interval between pregnancies on perinatal outcomes.
        N Engl J Med. 1999; 340: 589-594
        • Smith G.C.
        • Pell J.P.
        • Dobbie R.
        Interpregnancy interval and risk of preterm birth and neonatal death: retrospective cohort study.
        BMJ. 2003; 327: 313
        • Fuentes-Afflick E.
        • Hessol N.A.
        Interpregnancy interval and the risk of premature infants.
        Obstet Gynecol. 2000; 95: 383-390
        • Cleary R.
        • Beard R.W.
        • Coles J.
        • et al.
        The quality of routinely collected maternity data.
        Br J Obstet Gynaecol. 1994; 101: 1042-1047
        • Bugg G.J.
        • Atwal G.S.
        • Maresh M.
        Grandmultiparae in a modern setting.
        BJOG. 2002; 109: 249-253
        • Saigal S.
        • Doyle L.W.
        An overview of mortality and sequelae of preterm birth from infancy to adulthood.
        Lancet. 2008; 371: 261-269
        • Moser K.
        • Macfarlane A.
        • Chow Y.H.
        • Hilder L.
        • Dattani N.
        Introducing new data on gestation-specific infant mortality among babies born in 2005 in England and Wales.
        Health Stat Q. 2007; Autumn: 13-27
        • Caughey A.B.
        • Musci T.J.
        Complications of term pregnancies beyond 37 weeks of gestation.
        Obstet Gynecol. 2004; 103: 57-62
        • Grausz J.P.
        • Heimler R.
        Asphyxia and gestational age.
        Obstet Gynecol. 1983; 62: 175-179
        • Ehrenstein V.
        • Pedersen L.
        • Holsteen V.
        • Larsen H.
        • Rothman K.J.
        • Sorensen H.T.
        Postterm delivery and risk for epilepsy in childhood.
        Pediatrics. 2007; 119: e554-e561
        • Lindstrom K.
        • Fernell E.
        • Westgren M.
        Developmental data in preschool children born after prolonged pregnancy.
        Acta Paediatr. 2005; 94: 1192-1197
        • Tita A.T.
        • Landon M.B.
        • Spong C.Y.
        • et al.
        Timing of elective repeat cesarean delivery at term and neonatal outcomes.
        N Engl J Med. 2009; 360: 111-120
        • Zhou W.
        • Olsen J.
        • Nielsen G.L.
        • Sabroe S.
        Risk of spontaneous abortion following induced abortion is only increased with short interpregnancy interval.
        J Obstet Gynaecol. 2000; 20: 49-54
        • Barnett A.G.
        • van der Pols J.C.
        • Dobson A.J.
        Regression to the mean: what it is and how to deal with it.
        Int J Epidemiol. 2005; 34: 215-220