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Am J Perinatol 2023; 40(02): 201-205
DOI: 10.1055/s-0041-1728819
Original Article

Measuring Variation in Interpregnancy Interval: Identifying Hotspots for Improvement Initiatives

Scarlett D. Karakash
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
,
Elliott K. Main
2   California Maternal Quality Care Collaborative, Stanford University School of Medicine, Stanford, California
,
Shen Chih Chang
3   California Maternal Quality Care Collaborative, Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
,
Gary M. Shaw 
4   March of Dimes Prematurity Research Center at Stanford University School of Medicine and Lucile Packard Children's Hospital at Stanford, Stanford University School of Medicine, Stanford, California
,
David K. Stevenson
4   March of Dimes Prematurity Research Center at Stanford University School of Medicine and Lucile Packard Children's Hospital at Stanford, Stanford University School of Medicine, Stanford, California
,
Jeffrey B. Gould
5   California Perinatal Quality Care Collaborative, Stanford University School of Medicine, Stanford, California
› Author Affiliations Funding None.
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Abstract

Objective The study aimed to determine if single year birth certificate data can be used to identify regional and hospital variation in rates of short interpregnancy interval (IPI < 6 months).

Study Design IPI was estimated for multiparous women ages 15 to 44 years with singleton live births between 2015 and 2016. Perinatal outcomes, place of birth, maternal race, and data for IPI calculations were obtained by using birth certificates. IPI frequencies are presented as observed rates.

Results The cohort included 562,039 multiparous women. Short IPI rates were similar to those obtained with analyses by using linked longitudinal data and confirmed the association with preterm birth. Short IPI rates varied by race and Hispanic nativity. There was substantial hospital (0.8–9%) and regional (2.9–6.2%) variation in short IPI rates.

Conclusion IPI rates can be reliably obtained from current year birth certificate data. This can be a useful tool for quality improvement projects targeting interventions and rapidly assessing their progress to promote optimal birth spacing.

Key Points

  • Near-real time regional and hospital IPI rates can be reliably obtained from current year birth certificate data.

  • Substantial variations in rates of short IPI exist between hospital and perinatal regions.

  • IPI rates from individual birth certificates can be a tool to target and assess interventions.

Keywords

interpregnancy interval - preterm birth - quality improvement - maternal disparities


Publication History

Received: 20 May 2020

Accepted: 02 March 2021

Article published online:
03 May 2021

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