(Reuters Health) – Women just waiting to get pregnant after delivering children may lay down and their next child at…
“We found women of all ages, pregnancy within 12 months after a living birth was at risk,” said study leader Laura Schummers, currently a postdoctor at the University of British Columbia. The study was part of Schummer’s dissertation at Harvard School of Public Health.
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 a chance to have more than one child, said Schummers.
“Women who are 35 years of age and older often plan to have close range of pregnancies,” said Schummers. “Among younger women, pregnancy is planned less often if it is close to each other. If someone has a baby and six months later, they discover that they are pregnant, maybe not intended. We thought that older women plan to get their pregnancies closer, they may not have the increased risks caused by accidental pregnancies. “
As it turned out, there were less complications among older women’s children compared to younger women. But there was still a slight increased risk when the distance between pregnancies was short, the authors reported in JAMA Internal Medicine.
However, contrary to what the researchers had expected, short intervals between pregnancies ̵
1; six to 18 months – were associated with higher risks 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 older women, but not younger women.
To study 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 period.
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 periods 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, added: “You must balance it against the fact that when you grow older, the likelihood of becoming pregnant decreases. If you wait too long it may be difficult to get pregnant at all. “
Dr. Leena Nathan often finds himself discussing the balance with his elderly patients.
“Many of my patients are older than 35 when they have their first child,” said Nathan, a deputy clinical professor of obstetrics and gynecology at the University of California, Los Angeles, and Medical Director of the UCLA Community OBGYN Practice. “Many of them have short intervals 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 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 deny a shorter interval pregnancy in these patients.”
Source: bit.ly/2yJj11Y and bit.ly/2yGgMfS JAMA Internal Medicine, online October 29, 2018.
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