Attempted Pregnancy Following a Miscarriage Need Not Be Postponed

Women who conceive within six months of an initial miscarriage have the best chance of having a healthy pregnancy with the lowest complication rates, according to a new study.

Researchers at the University of Aberdeen (United Kingdom) conducted a population based retrospective cohort study to determine the optimum interpregnancy interval after miscarriage in a first recorded pregnancy. To do so, they reviewed data from Scottish hospitals between 1981 and 2000; a total of 30,937 women who had a miscarriage in their first recorded pregnancy and subsequently became pregnant were included in the study. The main outcome measures were miscarriage, live birth, termination, stillbirth, or ectopic pregnancy in the second pregnancy. Secondary outcomes were rates of caesarean section and preterm delivery, low birth-weight infants, preeclampsia, placenta previa, placental abruption, and induced labor in the second pregnancy.

The results showed that compared with women with an interpregnancy interval of 6-12 months, those who conceived again within six months were less likely to have another miscarriage, termination, or ectopic pregnancy. Women who conceived again within six months and went on to have a live birth in the second pregnancy were also less likely to have a caesarean section, preterm delivery, or infant of low birth weight, but were more likely to have an induced labor. Women with an interpregnancy interval of more than 24 months were more likely to have an ectopic second pregnancy or termination. The study was published ahead of print on August 3, 2010, in BMJ.

"Women who conceive within six months of an initial miscarriage have the best reproductive outcomes and lowest complication rates in a subsequent pregnancy,” concluded lead author professor of reproductive medicine Sohinee Bhattacharya, M.D., and colleagues. "Our research shows that it is unnecessary for women to delay conception after a miscarriage.”

Delaying getting pregnant is particularly problematic in the western world, since women over 35 are more likely to experience difficulties in conceiving, and women aged 40 years have a 30% chance of miscarriage, which rises to 50% in those aged 45 years or more. As a result, any delay in attempting conception could further decrease the chance of a healthy baby.

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