Conceiving too soon or too long after giving birth may increase the risk of preterm birth, according to new research.
The importance of adequate birth spacing has been highlighted by the study, which was recently published in the British Journal of Obstetrics and Gynaecologists.
The study found that women who conceive less than 11 months after giving birth have a higher chance of going into labour or being medically induced before 37 weeks of gestation. In addition, the odds of a premature birth are also increased for those who wait three years to have another baby, suggested the study.
The study used data from a million women in California who gave birth between 2007 and 2010, in order to assess whether interpregnancy interval was associated with preterm birth in women who had already given birth and those who had experienced a pregnancy loss (miscarriage, stillbirth or abortion).
A short interpregnancy interval was defined as conception after less than 18 months and a long interval was after more than 36 months. According to best medical practice, an interval of 18 to 23 months is considered the optimal interpregnancy interval, when the risk of preterm birth is roughly one in 17.
The results showed that women who conceive less than six months after giving birth have a 70% higher risk of preterm birth than women with an optimal interpregnancy interval, while the risk for those with an interpregnancy interval of six to 11 months is 20% higher.
Women who wait 36 to 48 months also have a slightly increased risk of going into labour or being induced early.
An estimated 15 million babies are born prematurely worldwide each year and preterm birth complications are the leading cause of death among children under five years of age, responsible for nearly 1 million deaths annually.
Lead author, Dr Bat Zion Shachar from the March of Dimes Prematurity Research Centre at Stanford University in California, said that reducing the rate of premature births globally is a priority.
“This study adds to our understanding about the potential causes of preterm birth and highlights the importance of communicating the risks of inadequate birth spacing to women. We recommend that obstetricians and midwifes discuss child spacing plans with postpartum mothers, as well as encouraging the use of contraception to reduce the likelihood of unplanned pregnancy occurring soon after live births.”
Professor Lesley Regan, President Elect for the Royal College of Obstetricians and Gynaecologists (RCOG) commented that approximately 225 million women across the world have no access to family planning.
“Therefore they have little control over whether and when they become pregnant. Providing women across the world with the choice to use effective contraception and to space their babies by 24 months or more, would prevent 54 million unintended pregnancies, 79,000 maternal deaths and 1.1 million infant deaths.”
Professor Regan added that the findings stress the importance of birth spacing plans for optimal child health.
“Family planning is a key international priority that should not only be regarded as an intervention for improving health, but also as a human right,” she commented.
Our recently published Safe Motherhood Report found that family planning was infrequently discussed with doctors and healthcare professionals: over half of the women who responded to the survey said that family planning had not been discussed.
The study, entitled “Interpregnancy interval after live birth or pregnancy termination and estimated risk of preterm birth: a retrospective cohort study” can be found at: http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.14165/full