By Linda Carroll (Reuters Health) – Women just waiting to get pregnant after delivering children can lay down and their…
By Linda Carroll
“We found for women of all ages, pregnancy within 12 months after a live birth was at risk,” said study leader Laura Schummers, currently a postdoctoral professor at the University of British Columbia. The study was part of Schummer’s dissertation at Harvard Folkhälsohögskolan.
When Schummers and her colleagues began the study, they thought they could find lower risks among older women. This is due to the fact that most of these short pregnancies in older women are of choice: the women are at an age where their fertility decreases and they want more than one child, says Schummers.
“Women of 35 and older are planning to keep close distance from pregnancies,” says Schummers. “Among younger women, pregnancy is planned less if it is close to each other. If someone has a baby and six months later, they discover that they are pregnant, maybe it is not supposed. We believed that older women more often plan to get their pregnancies closer together, and they may not have the increased risks caused by accidental pregnancies. “
As shown, there were fewer complications among older women’s children compared to younger women. However, there was still a slight increased risk when the distance between pregnancies was short, the authors reported in JAMA Internal Medicine.
However, as opposed to what the researchers had expected were short periods between pregnancies – six to 18 months – associated with higher risk of death and serious complications (such as transfusions of three or more blood units, put on a fan, transferred to an intensive care or organ failure) for elderly women, but not younger women.
To look more closely at the effects of interpregnancy intervals, Schummers and her colleagues turned to the British Columbia Perinatal Data Registry, a database containing a summary of information retrieved from obstetric and newborn journals. In the end, researchers could look at 148,544 pregnancies that occurred during a 10-year p eriod.
Although the study is interesting, it is not clear how well it would be for American patients. Dr Tarun Jain, a professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine and a fertility specialist at Northwestern Medicine. “I think it’s important to be aware that these results may not be generalized,” he said.
“Another important point,” said Jain, that while shorter intervals between pregnancies were associated with higher risks for older women “the risk was still relatively low.”
Jain, who was not affiliated with the new research, allowed : “You have to balance it against the fact that when you grow older, the likelihood of becoming pregnant decreases. For a long time it can be difficult to get pregnant at all.”
Dr. Leena Nathan often finds that she discusses the balance with her elderly patients.
“Many of my patients are over 35 when they have their first child,” said Nathan, a deputy clinical professor at the Department of Obstetrics and Gynecology at California, Los Angeles, and Medical Director of the UCLA Community OBGYN Practices. “And many of them have short interval between pregnancies because they are worried about their fertility. It’s really a discussion during the postpartum search after the first delivery.”
Nathan does not expect the 40-somethings to spend too much time between pregnancies. “In my mothers over 40, I advise them about fertility rates and genetic mutations as they continue to age,” said Nathan, who was not involved in the new research, said in an email. “These patients are generally very motivated and will take care of themselves for a healthy subsequent pregnancy, even if it is less than an 18 month interval. I do not discourage a shorter pregnancy interval in these patients.”  Source: http://bit.ly/2yJj11Y and http://bit.ly/2yGgMfS JAMA Internal Medicine, Online October 29, 2018.