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We included studies meeting the following criteria: (a) reporting of perinatal health outcomes after a short interpregnancy interval since last livebirth; (b) conducted within a high\u2010resource setting; and (c) estimates were adjusted for maternal age and at least one socio\u2010economic factor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine good\u2010quality and 18 fair\u2010quality studies were identified. Interpregnancy intervals &lt;6\u00a0months were associated with a clinically and statistically significant increased risk of adverse outcomes in studies of preterm birth (eg, a<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0\u2265\u00a01.20 in 10 of 14 studies); spontaneous preterm birth (eg, <jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>\u00a0\u2265\u00a01.20 in one of two studies); small\u2010for\u2010gestational age (eg, <jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>\u00a0\u2265\u00a01.20 in 5 of 11 studies); and infant mortality (eg, <jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>\u00a0\u2265\u00a01.20 in four of four studies), while four studies of perinatal death showed no association. Interpregnancy intervals of 6\u201011 and 12\u201017\u00a0months generally had smaller point estimates and confidence intervals that included the null. Most studies were population\u2010based and few included adjustment for detailed measures of key confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In high\u2010resource settings, there is some evidence showing interpregnancy intervals &lt;6\u00a0months since last livebirth are associated with increased risks for preterm birth, small\u2010for\u2010gestational age and infant death; however, results were inconsistent. Additional research controlling for confounding would further inform recommendations for healthy birth spacing for the United States.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12503","type":"journal-article","created":{"date-parts":[[2018,10,24]],"date-time":"2018-10-24T19:52:27Z","timestamp":1540410747000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":120,"title":["Short interpregnancy intervals and adverse perinatal outcomes in high\u2010resource settings: An updated systematic review"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5139-9208","authenticated-orcid":false,"given":"Katherine A.","family":"Ahrens","sequence":"first","affiliation":[{"name":"Office of Population Affairs Office of the Assistant Secretary for Health U.S. Department of Health and Human Services  Rockville Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Clinical Epidemiology Oregon Health &amp; Science University  Portland Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reva L.","family":"Stidd","sequence":"additional","affiliation":[{"name":"Atlas Research LLC  Washington District of Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Moskosky","sequence":"additional","affiliation":[{"name":"Office of Population Affairs Office of the Assistant Secretary for Health U.S. Department of Health and Human Services  Rockville Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0502-3423","authenticated-orcid":false,"given":"Jennifer A.","family":"Hutcheon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728-4465.2012.00308.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.15.1809"},{"key":"e_1_2_8_4_1","unstructured":"World Health Organization.Report of a WHO Technical Consultation on Birth Spacing: Geneva Switzerland 13\u201315 June 2005. 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