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Rapidly consecutive pregnancies a risk for mother and child?
Pregnancy and the subsequent birth are associated with considerable stresses on the body, so that the body should regenerate before a new pregnancy follows. But how long does it take the body to do this? And what are the risks of short intervals between birth and a new pregnancy?
Scientists from the University of British Columbia (UBC) and Harvard T.H. In a recent study, Chan School of Public Health examined how the time interval between the last birth and a new pregnancy affects the health of mother and child. A break of at least one year should therefore be observed in order to avoid unnecessary health risks. The doctors published their results in the journal "JAMA Internal Medicine".
Almost 150,000 pregnancies evaluated
Many couples wish to have several children and are faced with the question of how long they should best wait after their first birth. In their current study, the US scientists have now carried out an assessment from a medical point of view. For this purpose, they analyzed the effects of the time interval between pregnancies on the risks for mothers and babies in 148,544 pregnancies. The data was compiled from birth records, invoice codes, hospital data, prescription data and census records.
Increased risk of maternal mortality
The research team led by University of British Columbia lead author Laura Schummers found that women over the age of 35 who became pregnant six months after a previous birth were at 1.2 percent (12 cases per 1,000 pregnancies) or at risk of maternal mortality severe morbidity. With a waiting period of 18 months between pregnancies, this risk was reduced to 0.5 percent (five cases per 1,000 pregnancies).
Increased premature births with a short pregnancy distance
In younger women (20 to 34 years), the researchers found a significantly increased risk of premature birth (8.5 percent) if the interval between pregnancies was only six months. If the interval was at least 18 months, the risk dropped to 3.7 percent (37 cases per 1,000 pregnancies). Women over the age of 35 were also at greater risk of spontaneous premature birth if they were only six months apart - around six percent compared to 3.4 percent at an interval of 18 months.
Risk for children increases especially among younger women
An increased risk of undesirable fetal and child-related consequences due to an insufficient pregnancy gap was particularly noticeable among the younger women (2% after 6 months versus 1.4% after 18 months), whereas the older women showed only slight differences (2.1 % after 6 months versus 1.8% after 18 months).
Schedule a twelve to 18 month break
Overall, the "study found an increased risk for mother and child when pregnancies are close, including for women older than 35 years," emphasized the study’s lead author, Laura Schummers, in a UBC press release. The results are particularly important for older women, as they would often tend to plan their pregnancies more closely. Twelve to 18 months seem to be the ideal time between birth and a new pregnancy, reports the expert.
The causes of the increased health risks are unclear
The current study does not show why the short pregnancy intervals lead to increased health risks, but the scientists have some assumptions here. For example, “short pregnancy intervals may reflect unplanned pregnancies, especially in young women,” explains Dr. Sonia Hernandez-Diaz, Professor of Epidemiology at Harvard T.H. Chan School of Public Health. This could be accompanied by factors such as poorer birth preparation.
Observe compliance with the pregnancy distance
"Whether the increased risks are due to the fact that our body does not have time to recover when we become pregnant shortly after childbirth, or to factors associated with unplanned pregnancies," remains unclear, but the recommendations are from this independent, said Hernandez-Diaz. It was important to improve contraception immediately after birth and to avoid unprotected sex.
Verifiable statements on the ideal pregnancy distance
For the first time, the latest study results offer mothers verifiable statements to determine the ideal distance between their pregnancies, emphasizes Dr. Wendy Norman from the University of British Columbia. "Achieving this optimal one-year interval should be feasible for many women and is clearly worth it to reduce the risk of complications"; the expert concluded. The study is the most comprehensive assessment to date of how the pregnancy gap affects maternal mortality, severe morbidity and life-threatening complications during pregnancy and childbirth. (fp)