Women who conceived within six months of having a miscarriage or abortion did not appear to be at increased risk of a problem pregnancy, new study of more than 70,000 births in Norway finds became.
Survey results, Published online today of pros medicineshould help women and clinicians navigate conflicting guidance on how long it takes to be safe to conceive again after giving birth. abortionGizachew Tessema, Ph.D., Senior Research Fellow at Curtin University, Perth, Australia, and lead author of the study, said:
“Especially after a miscarriage, women want to get pregnant again,” Tesema said. Medscape Medical News“Why should they wait if the risk is not increased?”
Internationally, the World Health Organization advises patients not to try to conceive for at least 6 months after an abortion or miscarriage. These his 2007 recommendations spurred Tessema and his colleagues to delve deeper into the risk factors associated with pregnancies after shorter intervals.
Two-thirds of the women in the study became pregnant again within six months of the miscarriage. Only a quarter of women who had an abortion got pregnant again within the same period.
Dr. Gizachu Tesema
Using the Norwegian National Health Register, researchers examined the outcomes of 49,058 births after miscarriage and 23,707 births after induced abortion between 2008 and 2016. How are miscarriages or abortions identified? This study included only miscarriages reported through the healthcare system.
Expanding on other studies that have shown no adverse outcomes at these inter-pregnancy intervals, Tessema and colleagues found that women who became pregnant shortly after a miscarriage or abortion did not have an increased risk of premature birth and had smaller newborns. . gestation period (SGA) or large for gestational age (LGA), or developing preeclampsia Also gestational diabetes.
Tessema and his colleagues found a slightly lower proportion of women who conceived within 3 months (8.6% to 10.1%) compared to those who conceived within 6–11 months after miscarriage. . Fewer, but not statistically significant, women became pregnant within her 3 months of induced abortion (P. = .07), with an increased risk of SGA (11.5% to 10%) compared with those aged 6–11 months.
Women who conceived within 6 months of abortion or miscarriage were not shown to be at greater risk for other adverse outcomes such as preterm birth, LGA, pre-eclampsia, and GDM.
According to Scott Sullivan, M.D., director of high-risk obstetrics and gynecology at Inova Health in Fairfax, Virginia, the results should reassure women who want to get pregnant again shortly after an abortion or miscarriage.
Patients often hear conflicting advice from doctors, friends, or medical associations about the best time to try a baby after a miscarriage or abortion. This is partly due to differences in various guidelines. Adding to the confusion is the lack of robust research and data on pregnancy loss, especially in the United States, he said.
“The whole topic of miscarriage is underestimated by the general public, how painful it is for people and how common it is,” Sullivan told Medscape. We don’t even track them as regularly in the US as they do in other countries.”
Sullivan says he usually tells his patients to get pregnant again as soon as possible. As recommended by the American College of Obstetricians and Gynecologists, This indicates that the patient can become pregnant two weeks after giving birth. early miscarriage.
However, not all patients are mentally ready to try again right away, especially if they are still lamenting the miscarriage.
“Even though they are physically ready, many people are not emotionally ready because of the grieving process,” Sullivan said. “It’s very different for people. ”
WHO guidelines for developed countries
WHO has developed guidelines based on research from low-income countries. This includes her one study across Latin America that concluded that women who waited less than six months to conceive after an abortion or miscarriage had worse pregnancy outcomes.
Tessema said his research was limited because it focused on Norway, a high-income country where women have guaranteed access to health care. He said the results could be worse in large developing countries.
“The problem is when this international guideline was produced, and most of the evidence comes from low- and middle-income countries,” Tesema said. “No studies were done in high-income cities. said, ‘This is a different situation.'” These recommendations may not be suitable for this setting. ”
This study was funded by the Centers of Excellence funding program of the Norwegian Research Council, the National Health and Medical Research Council, the Raine Medical Research Foundation and the European Research Council under the European Union’s Horizon 2020 Research and Innovation Programme. I received an offer. None of the authors reported relevant financial relationships.
PLOS Medicine. Published online on November 22, 2022. full text
Amanda Schmidt is a journalist based in Virginia.
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