Menstrual cycle length and adverse pregnancy outcomes among women in Project Viva

Feb 16, 2022Paediatric and perinatal epidemiology

Menstrual cycle length and pregnancy problems in women from Project Viva

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Abstract

The study analyzed data from 2046 women and found that short menstrual cycles are associated with lower odds of gestational diabetes, while long or irregular cycles are linked to higher odds of the same condition.

Women with short menstrual cycles (≤25 days) had lower odds of gestational diabetes or impaired glucose tolerance (odds ratio 0.50).
Women with long or irregular cycles (≥35 days or too irregular) had higher odds of gestational diabetes or impaired glucose tolerance (odds ratio 1.72).
Short cycles were associated with higher odds of newborns in the lowest tertile of birthweight-for-gestational age (odds ratio 1.45).
A U-shaped relationship was observed between menstrual cycle length and preterm birth, with both short and long cycles associated with increased risk.
Short cycles showed a relative risk of 1.49 and long/irregular cycles showed a relative risk of 2.04 for preterm birth.

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BACKGROUND: Retrospective studies suggest that menstrual cycle length may be a risk marker of adverse pregnancy outcomes, but this evidence is susceptible to recall bias.

OBJECTIVE: To evaluate the prospective association between menstrual cycle length and the risk of adverse pregnancy outcomes.

METHODS: Secondary analysis of 2046 women enrolled in Project Viva at ~10 weeks of gestation and followed through delivery. The exposure was menstrual cycle length. The outcomes included gestational glucose tolerance (gestational diabetes/impaired glucose tolerance [GDM/IGT] and isolated hyperglycaemia), hypertensive disorders of pregnancy (gestational hypertension/preeclampsia), gestational weight gain, birthweight-for-gestational age z-scores (BWZ) categorised in tertiles, preterm birth and birth outcome (live birth and pregnancy loss). We used modified Poisson and multinomial logistic regression adjusted for age, race/ethnicity, parity, age at menarche and pre-pregnancy body mass index.

RESULTS: Mean (SD) age at enrolment was 32.1 (4.9) years. Most women (74.3%) had a cycle length of 26-34 days (reference group), 16.2% reported short cycles (≤25 days), and 9.5% reported long/irregular cycles (≥35 days/too irregular to estimate). Compared with the reference group, women with short cycles had lower odds of GDM/IGT (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.28, 0.89), whereas women with long/irregular cycles had higher odds (OR 1.72, 95% CI 1.04, 2.83). Additionally, women with short cycles had higher odds of having a newborn in the lowest tertile of BWZ (OR 1.45, 95% CI 1.06, 1.98). There was a U-shaped relation between cycle length and preterm birth with both short (relative risk [RR] 1.49, 95% CI 0.98, 2.27) and long/irregular (RR 2.04, 95% CI 1.30, 3.20) cycles, associated with a higher risk.

CONCLUSIONS: Variation in menstrual cycle length may be a risk marker of GDM/IGT, lower birth size and preterm birth and flag women who may benefit from targeted monitoring and care before and during pregnancy.

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Menstrual cycle length and adverse pregnancy outcomes among women in Project Viva

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