Short and long interpregnancy interval and the risk for pediatric obstructive sleep apnea in the offspring

Hila Rapaport Pasternak, Eyal Sheiner, Aviv Goldbart, Tamar Wainstock

Research output: Contribution to journalArticlepeer-review


Introduction: Interpregnancy interval (IPI) is defined as the period between a live birth and the conception of a subsequent fetus. Both short (IPI < 6 months) and long IPI (IPI > 60 months) have been shown to increase the risk for adverse perinatal outcomes, some of which, are known risk factors for obstructive sleep apnea syndrome (OSAS) in the offspring. Aims: To study the association between IPI and risk for offspring OSAS, during a follow-up period of up to 18 years. Study design: Population-based cohort. Subjects: In this population-based cohort analysis, all singleton live births, born to a mother with at least one previous birth occurring between 1991 and 2014, were included. Congenital malformations were excluded. Materials and Methods: Hospitalizations of the offspring due to OSAS diagnosis up to 18 years of age, were evaluated according to IPI length. Intermediate IPI (6–60 months) was considered as the reference. A Kaplan-Meier survival curve and a Cox hazards regression model were used to compare the incidence of OSAS between the groups, and to adjust for confounding variables. Results: The study population included 144,397 deliveries, of which 13.1% (n = 18,947) were followed by short IPI, 7.9% (n = 11,438) and 79.0% (n = 114,012) were followed by long and intermediate IPI, respectively. OSAS hospitalization rates were significantly higher among the long IPI group compared to intermediate and short IPIs (0.9%; 0.7% and 0.6%, respectively, p =.001). The association between long IPI and offspring pediatric OSAS remained significant after controlling for preterm delivery, maternal diabetes, and smoking, and mode of delivery, (adjusted HR = 1.45; 95% CI, 1.17–1.80). Conclusions: Children born following long IPI are at increased risk for pediatric OSAS.

Original languageAmerican English
Pages (from-to)1085-1091
Number of pages7
JournalPediatric Pulmonology
Issue number5
StatePublished - 1 May 2021


  • interpregnancy interval
  • obstructive sleep apnea
  • population based cohort

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine


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