Interpregnancy interval and adverse pregnancy outcomes among pregnancies following miscarriages or induced abortions in Norway (2008-2016): A cohort study

The World Health Organization recommends to wait at least 6 months after miscarriage and induced abortion before becoming pregnant again to avoid complications in the next pregnancy, although the evidence-based underlying this recommendation is scarce. We aimed to investigate the risk of adverse pre...

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Bibliographic Details
Published in:PLoS medicine 2022-11, Vol.19 (11), p.e1004129-e1004129
Main Authors: Tessema, Gizachew A, Håberg, Siri E, Pereira, Gavin, Regan, Annette K, Dunne, Jennifer, Magnus, Maria C
Format: Article
Language:English
Subjects:
Abortion, Induced
Abortion, Spontaneous - epidemiology
Abortion, Spontaneous - etiology
Birth Intervals
Cohort Studies
Diabetes, Gestational
Female
Fetal Growth Retardation
Humans
Infant, Newborn
Infant, Newborn, Diseases
Medicine and Health Sciences
Pregnancy
Pregnancy Outcome - epidemiology
Premature Birth - epidemiology
Premature Birth - etiology
Retrospective Studies
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Summary:The World Health Organization recommends to wait at least 6 months after miscarriage and induced abortion before becoming pregnant again to avoid complications in the next pregnancy, although the evidence-based underlying this recommendation is scarce. We aimed to investigate the risk of adverse pregnancy outcomes-preterm birth (PTB), spontaneous PTB, small for gestational age (SGA) birth, large for gestational age (LGA) birth, preeclampsia, and gestational diabetes mellitus (GDM)-by interpregnancy interval (IPI) for births following a previous miscarriage or induced abortion. We conducted a cohort study using a total of 49,058 births following a previous miscarriage and 23,707 births following a previous induced abortion in Norway between 2008 and 2016. We modeled the relationship between IPI and 6 adverse pregnancy outcomes separately for births after miscarriages and births after induced abortions. We used log-binomial regression to estimate unadjusted and adjusted relative risk (aRR) and 95% confidence intervals (CIs). In the adjusted model, we included maternal age, gravidity, and year of birth measured at the time of the index (after interval) births. In a sensitivity analysis, we further adjusted for smoking during pregnancy and prepregnancy body mass index. Compared to births with an IPI of 6 to 11 months after miscarriages (10.1%), there were lower risks of SGA births among births with an IPI of
ISSN:1549-1676
1549-1277
1549-1676
DOI:10.1371/journal.pmed.1004129