Pregnancy shortly after a miscarriage is no more risky • The Medical Republic

Women who become pregnant shortly after a spontaneous or induced abortion are not at greater risk of complications.

Women who conceive within three months of a miscarriage or abortion are not at higher risk for common pregnancy complications, an Australian-led study suggests.

The Curtin University-led analysis included Norwegian data on 49,000 births after miscarriage and 23,000 births after induced abortion over eight years.

The retrospective cohort study in PLOS medicine found no increased risk of preterm birth, low and high birth weight, preeclampsia and gestational diabetes in women who became pregnant within three or six months of a miscarriage or abortion.

The World Health Organization recommends that women wait at least six months before trying to conceive after a miscarriage or induced abortion.

“Our current study results do not support current WHO recommendations and suggest that international guidelines should be revised,” lead author Dr. Gizachew Tessema, of the Curtin School of Population Health, said in a statement.

“We also found no evidence of higher risks for women who became pregnant more than 12 months after a miscarriage or induced abortion.

“Instead, we found that women had a lower risk of pregnancy complications such as low birth weight and gestational diabetes if they conceived within three months of a miscarriage.

“One possible explanation for this is that women who chose to conceive shortly after a miscarriage were more likely to plan to conceive and therefore may have sought medical attention to avoid a further complication.”

The researchers also found no evidence that women who became pregnant more than 12 months after a miscarriage or induced abortion had a higher risk of adverse pregnancy outcomes.

However, they found a “modest” (6%) increased risk of gestational diabetes in women with a gestational interval of 12 to 23 months.

“Our results are promising for families hoping to conceive after an early pregnancy loss, but further research is needed to explore the link,” said Dr. Tessema.

RANZCOG’s advice for women trying to conceive after an uncomplicated pregnancy loss is to wait out at least one menstrual period and aim to time the next pregnancy when women feel emotionally strong and ready.

The guidelines also advise women to monitor any long-term health problems, reduce cigarette, alcohol or drug use, and maintain a healthy weight.

The authors said there was a reduced risk of small-for-gestational age babies in women who conceived within five months.

“Women who were able to conceive quickly after a miscarriage may have better fertility rates due to the high reproductive fitness of women compared to women with a longer inter-pregnancy interval,” they wrote.

“Despite the assumption that women with previous pregnancies that resulted in live births may have had nutrient deficiencies, which usually occur in the second trimester and early postpartum period from breastfeeding, it is plausible that women with miscarriages would not reach the point where dietary supplements become depleted. starts because most miscarriages usually occur in the first 12 weeks.

The researchers noted that they only had information about miscarriages that resulted in contact with the health care system.

“Since our study used data from a single high-income country with better health care, our results could not be generalized to other settings with different populations,” they wrote.

When the researchers adjusted the findings for smoking before and during pregnancy, and for BMI before pregnancy, the results were the same.

PLOS Medicine 2022, online November 22

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