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Predicting Time to Subsequent Pregnancy

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Objectives: Women in poverty may benefit from avoiding closely spaced pregnancies. This study sought to identify predictive factors that could identify women at risk for closely spaced pregnancies. Methods: We studied 20,028 women receiving welfare (cash assistance) from Washington State. Using Cox proportional hazards methods, we estimated the effects of individual- and community-level variables on time from an index birth until a subsequent pregnancy (between June 1992 and December 1999). Prediction models developed in a random half of our data were validated in the other half. Receiver operator characteristic plots appropriate for proportional hazards models were calculated to compare the sensitivity and specificity of each model. Results: At 5 years of follow-up, the most predictive model contained just individual-level variables (age, education, race, marital status, number of prior pregnancies); the area under the receiver operator characteristic curve was 0.66 (.62–.69). The addition of community-level variables (percent in poverty, with a high school degree or higher, Black, Hispanic, in an urban area; female unemployment rate; income inequality) added little predictive ability. Differences were found between women with different individual- and community-level characteristics, but the results suggest that these factors are not strong predictors of pregnancy spacing. Conclusions: Individual- and community-level characteristics are associated with interpregnancy intervals; however, we found little evidence that the selected variables predicted pregnancy interval in a useful manner.

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Author notes

  1. Rachel Gold PhD, MPH

    Present address: Department of Public Health and Preventive Medicine, Oregon Health Sciences University, Kaiser Permanente Center for Health Research, Portland, Oregon, USA

Authors and Affiliations

  1. Department of Epidemiology, Washington State Department of Social and Health Services, Division of Research and Data Analysis, University of Washington (UW) School of Public & Community Medicine, 3325 SW Kelly Avenue, Portland, Oregon, 97239 503-528-3902, USA

    Rachel Gold PhD, MPH

  2. Academic Affairs, UW School of Public Health & Community Medicine, Health Services, Maternal & Child Health, University of Washington, Box 357230, F-358B HSB, Seattle, Washington, 98195, USA

    Frederick A. Connell MD, MPH

  3. Biostatistics, UW School of Public Health & Community Medicine, University of Washington, Box 357232, F-667 Health Sciences, Seattle, Washington, 98195, USA

    Patrick Heagerty PhD, MS

  4. Epidemiology, UW School of Public Health & Community Medicine, 250 Grandview Dr, Bishop, California, 93514, USA

    Peter Cummings MD, MPH & Robert Davis MD, MPH

  5. Health Services, UW School of Public Health & Community Medicine, University of Washington, Box 357660, H-673 HSB, Seattle, Washington, 98195, USA

    Stephen Bezruchka MD, MPH, MA

  6. Pediatrics, Child Health Institute, UW School of Public Health & Community Medicine, 146 N. Canal St, Ste #300, Seattle, Washington, 98103-8652, USA

    Robert Davis MD, MPH

  7. Washington State Department of Social and Health Services, Division of Research and Data Analysis, MS 45204, Olympia, Washington, USA, 98504-5000

    Mary Lawrence Cawthon MD, MPH

  8. Oregon Health Sciences University, Department of Public Health and Preventive Medicine, Kaiser Permanente Center for Health Research, Portland, Oregon, USA

    Rachel Gold PhD, MPH

Authors
  1. Rachel Gold PhD, MPH
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  2. Frederick A. Connell MD, MPH
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  3. Patrick Heagerty PhD, MS
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  4. Peter Cummings MD, MPH
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  5. Stephen Bezruchka MD, MPH, MA
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  6. Robert Davis MD, MPH
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  7. Mary Lawrence Cawthon MD, MPH
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Corresponding author

Correspondence to Rachel Gold PhD, MPH.

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Gold, R., Connell, F.A., Heagerty, P. et al. Predicting Time to Subsequent Pregnancy. Matern Child Health J 9, 219–228 (2005). https://doi.org/10.1007/s10995-005-0005-7

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  • DOI: https://doi.org/10.1007/s10995-005-0005-7

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