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 Researchers in the U.S. found that women participating in a larger
long-term study who conceived within three months of a pregnancy
loss had the lowest likelihood of another miscarriage compared to
women who waited 6 to 18 months.
“We observed that the advice doctors give to women about when to
start trying to get pregnant after experiencing a miscarriage varies
significantly,” senior study author Digna Velez Edwards told Reuters
Health in an email.
“Using the ‘Right from the Start’ prospective pregnancy cohort we
wanted to further examine this and see if the time between
pregnancies (interpregnancy interval) after a miscarriage influenced
a woman’s chance of having a miscarriage in her next pregnancy,”
said Velez Edwards, a researcher at Vanderbilt University Medical
Center in Nashville, Tennessee.
About 17% of clinically recognized pregnancies end in loss, the
study team writes online November 3 in Obstetrics & Gynecology. Most
women who experience a miscarriage want to know if they can prevent
another miscarriage and may ask their health care providers how long
they should wait before trying to conceive again.
The Right from the Start study included almost 6,000 women in North
Carolina, Tennessee and Texas who were pregnant or planning a
pregnancy between 2000 and 2012.
Participants filled out health interviews when they entered the
study and again at the end of their first trimester. All the women
underwent ultrasounds to confirm their pregnancies.
A total of 514 women said miscarriage was the outcome of their most
recent pregnancy before entering the study. Of those women, about
16% had a subsequent miscarriage.
When the study team compared interpregnancy intervals, they found
that women with intervals of less than three months had about a 7%
risk of repeat miscarriage, compared with a 22% risk for women who
waited 6 to 18 months weeks after the miscarriage to get pregnant
again.
Neither race, nor the number of children a woman already had, made a
difference in these results.
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Limitations of the study include its size, and the fact that
researchers could not assess whether the higher chances of
successful pregnancy after a shorter interval might be explained by
factors other than the length of the interval, such as the women’s
overall “high reproductive fitness.”
“Although our study demonstrated that getting pregnant within three
months of a previous miscarriage was associated with the lowest risk
of a subsequent miscarriage, when to start trying is specific to
each woman and depends on when she is ready to start trying again,”
Velez Edwards said.
The World Health Organization currently recommends waiting at least
6 months before attempting another pregnancy, the study team notes.
That advice is based on a single study, Velez Edwards said, and the
new results are consistent with more recent studies supporting
shorter intervals.
Women who are emotionally and physically ready to try to get
pregnant after a miscarriage may not have to delay getting pregnant
to reduce the risk of miscarriage, said Velez Edwards.
“If (women) want to try to get pregnant, there's no need to wait
unless they personally want to,” said Dr. Thomas Price, an
infertility specialist with Duke Health in Durham, North Carolina,
who wasn’t involved in the study.
Price noted that the American Congress of Obstetricians and
Gynecologists puts out bulletins with recommendations. “If you read
the ACOG recommendation in their bulletins, they do not recommend
any wait time after a miscarriage,” he said.
SOURCE: http://bit.ly/2m9Qj6n
Obstet Gynecol 2017.
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