Short inter-pregnancy interval; its associated factors and related pregnancy outcomes among admitted patients at Mnazi Mmoja Hospital –Zanzibar

Abstract

ABSTRACT Background: Short inter-pregnancy interval is associated with adverse outcomes that contribute towards maternal and neonatal morbidity and mortality. As we strive to advocate for adoption of the WHO inter-pregnancy interval in Zanzibar, we need to understand the detrimental effects in our local settings if not maintained within the recommended range. Aim: To determine the prevalence of short inter-pregnancy interval, its associated factors, and related pregnancy outcomes among women admitted at Mnazi Mmoja Hospital. Methodology: A total of 424 women were enrolled in an analytical cross-sectional study between October and December 2023. Structured questionnaires were used for data collection. SPSS Version 23 was used for data analysis. Logistic regression analysis was used to determine the measure of effect of the association between variables, estimated at 95% confidence interval and 5% level of significance. Results: The prevalence of short IPI was 35.6% with median age of 30 years, IQR [26-34]. Regarding use of family planning methods, non-use was significantly associated with increased odds of IPI (aOR=2.06, 95% CI=1.26-3.38). Likewise, compared with the older age group, the odds of short IPI was significantly increased with the younger women aged 25-29 (aOR=1.91, 95% CI=1.07-3.41) and 30-34 (aOR=1.99, 95% CI=1.12-3.54). In comparison with normal IPI, short IPI was associated with increased risk for stillbirth (aOR=2.38, 95% CI = 1.29-4.39), low birth weight (aOR=4.19, 95% CI = 2.62-6.71), premature babies (aOR=5.04, 95% CI = 2.84-8.91), NICU admissions (aOR=2.27, 95% CI = 1.33-3.86), maternal anemia (aOR=1.66, 95% CI = 1.09-2.54) and preterm labor (aOR=5.21, 95% CI = 3.07-8.83). Conclusion: More than a third of women at Mnazi Mmoja Hospital in Zanzibar practiced short IPI. As short IPI is a modifiable risk factor, adverse pregnancy outcomes can be prevented by addressing factors hindering adherence to the recommended IPI, particularly FP use.