The long and short of pregnancy intervals
By Reeta Raman, TODAY
SINGAPORE: When intervals between pregnancies, that is the time lapse between the delivery of the last child and the conception of the subsequent child, are shorter than 18 months and longer than 59 months, there are increased risks of low birth weight, small size for gestation age - measurement of time inside the uterus - and pre-term birth, according to an article in the Journal of the American Medical Association (JAMA).
Researchers analysed studies published between 1966 and 2006 to examine the association between birth spacing and the risk of adverse peri-natal - the period immediately before and after birth - outcomes.
The study discovered that infants of mothers with pregnancy intervals longer than 59 months had a 20 to 43 per cent higher risk of adverse outcomes.
The study also found out that in particular, inter-pregnancy intervals shorter than six months and longer than 50 months, about four years, were associated with an increased risk of foetal and early neo-natal death. Neo-natal death refers to death of the baby soon after birth. This association, however, is less clear.
There are a few explanations to comprehend the association between long and short inter-pregnancy intervals and the risk of adverse peri-natal outcomes, said Dr Law Wei Seng, registrar, department of general obstetrics and gynaecology, KK Women's and Children's Hospital (KKH).
For instance, one theory behind a short inter-pregnancy interval and unfavourable peri-natal outcome is that a mother who had just given birth would have poorer maternal nutrient stores to provide for her subsequent baby. This is because there is insufficient time to recover from the stress of her previous pregnancy before being subjected to another, said Dr Law.
Along the same lines, it is believed that the association with a long interval between pregnancy and unfavourable peri-natal outcome is that after delivery, a woman's reproductive capacity gradually declines, and eventually becomes similar to women who have never delivered before.
The authors of the study hope that their findings would encourage doctors to advise women on the benefits of delaying a subsequent pregnancy for approximately two to five years to improve the health of both mother and the next infant.
While the study is well-written, there are some limitations concerning the quality of the original data such as the differences in defining inter-pregnancy interval, said Dr Law.
"It may be too early to comment on the validity of this study unless more information can be provided to explain the mechanisms by which birth spacing might improve the health of mothers and their children," he said.
So the long and short of the study: The ideal interval between the delivery of the last child and the conception of the next child should be between one-and-a-half to two years, a view that Dr Law shares. He said: "Delaying conception for more than two years after the last delivery should be weighed against the risks that come with the mother's increasing age." - TODAY /dt
Copyright © 2006 MCN International Pte Ltd
Source:
http://www.channelnewsasia.com/stories/health/view/208539/1/.html
