Effect of interpregnancy interval on outcomes of pregnancy after miscarriage: retrospective analysis of hospital episode statistics in Scotland

Eleanor Love, Siladitya Bhattacharya, Norman Smith, Sohinee Bhattacharya

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Abstract

Objective To determine the optimum interpregnancy interval after miscarriage in a first recorded pregnancy. Design Population based retrospective cohort study.
Setting Scottish hospitals between 1981 and 2000. Participants 30 937 women who had a miscarriage in their first recorded pregnancy and subsequently became pregnant.
Main outcome measures The primary end point was miscarriage, live birth, termination, stillbirth, or ectopic pregnancy in the second pregnancy. Secondary outcomes were rates of caesarean section and preterm delivery, low
birthweight infants, pre-eclampsia, placenta praevia, placental abruption, and induced labour in the second pregnancy.
Results Compared with women with an interpregnancy interval of 6-12 months, those who conceived again within six months were less likely to have another
miscarriage (adjusted odds ratio 0.66, 95% confidence interval 0.57 to 0.77), termination (0.43, 0.33 to 0.57), or ectopic pregnancy (0.48, 0.34 to 0.69). Women with an interpregnancy interval of more than 24 months were more likely to have an ectopic second pregnancy (1.97, 1.42 to 2.72) or termination (2.40, 1.91 to 3.01). Compared with women with an interpregnancy interval of 6-12 months, women who conceived again within six months and went on to have a live birth in the second pregnancy were less likely to have a caesarean section
(0.90, 0.83 to 0.98), preterm delivery (0.89, 0.81 to 0.98), or infant of low birth weight (0.84, 0.71 to 0.89) but were more likely to have an induced labour (1.08, 1.02 to 1.23).
Conclusions Women who conceive within six months of an initial miscarriage have the best reproductive outcomes and lowest complication rates in a subsequent
pregnancy.
Original languageEnglish
Article numberc3967
Number of pages8
JournalBritish Medical Journal
Volume341
DOIs
Publication statusPublished - 5 Aug 2010

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Scotland
Spontaneous Abortion
Pregnancy Outcome
Ectopic Pregnancy
Pregnancy
Induced Labor
Live Birth
Cesarean Section
Placenta Previa
Abruptio Placentae
Stillbirth
Low Birth Weight Infant
Pre-Eclampsia
Cohort Studies
Retrospective Studies
Odds Ratio
Outcome Assessment (Health Care)
Confidence Intervals
Population

Cite this

@article{e3944670c3224a3292e1a90bdbf582cc,
title = "Effect of interpregnancy interval on outcomes of pregnancy after miscarriage: retrospective analysis of hospital episode statistics in Scotland",
abstract = "Objective To determine the optimum interpregnancy interval after miscarriage in a first recorded pregnancy. Design Population based retrospective cohort study. Setting Scottish hospitals between 1981 and 2000. Participants 30 937 women who had a miscarriage in their first recorded pregnancy and subsequently became pregnant. Main outcome measures The primary end point was miscarriage, live birth, termination, stillbirth, or ectopic pregnancy in the second pregnancy. Secondary outcomes were rates of caesarean section and preterm delivery, low birthweight infants, pre-eclampsia, placenta praevia, placental abruption, and induced labour in the second pregnancy. Results Compared with women with an interpregnancy interval of 6-12 months, those who conceived again within six months were less likely to have another miscarriage (adjusted odds ratio 0.66, 95{\%} confidence interval 0.57 to 0.77), termination (0.43, 0.33 to 0.57), or ectopic pregnancy (0.48, 0.34 to 0.69). Women with an interpregnancy interval of more than 24 months were more likely to have an ectopic second pregnancy (1.97, 1.42 to 2.72) or termination (2.40, 1.91 to 3.01). Compared with women with an interpregnancy interval of 6-12 months, women who conceived again within six months and went on to have a live birth in the second pregnancy were less likely to have a caesarean section (0.90, 0.83 to 0.98), preterm delivery (0.89, 0.81 to 0.98), or infant of low birth weight (0.84, 0.71 to 0.89) but were more likely to have an induced labour (1.08, 1.02 to 1.23). Conclusions Women who conceive within six months of an initial miscarriage have the best reproductive outcomes and lowest complication rates in a subsequent pregnancy.",
author = "Eleanor Love and Siladitya Bhattacharya and Norman Smith and Sohinee Bhattacharya",
year = "2010",
month = "8",
day = "5",
doi = "10.1136/bmj.c3967",
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journal = "BMJ",
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T1 - Effect of interpregnancy interval on outcomes of pregnancy after miscarriage

T2 - retrospective analysis of hospital episode statistics in Scotland

AU - Love, Eleanor

AU - Bhattacharya, Siladitya

AU - Smith, Norman

AU - Bhattacharya, Sohinee

PY - 2010/8/5

Y1 - 2010/8/5

N2 - Objective To determine the optimum interpregnancy interval after miscarriage in a first recorded pregnancy. Design Population based retrospective cohort study. Setting Scottish hospitals between 1981 and 2000. Participants 30 937 women who had a miscarriage in their first recorded pregnancy and subsequently became pregnant. Main outcome measures The primary end point was miscarriage, live birth, termination, stillbirth, or ectopic pregnancy in the second pregnancy. Secondary outcomes were rates of caesarean section and preterm delivery, low birthweight infants, pre-eclampsia, placenta praevia, placental abruption, and induced labour in the second pregnancy. Results Compared with women with an interpregnancy interval of 6-12 months, those who conceived again within six months were less likely to have another miscarriage (adjusted odds ratio 0.66, 95% confidence interval 0.57 to 0.77), termination (0.43, 0.33 to 0.57), or ectopic pregnancy (0.48, 0.34 to 0.69). Women with an interpregnancy interval of more than 24 months were more likely to have an ectopic second pregnancy (1.97, 1.42 to 2.72) or termination (2.40, 1.91 to 3.01). Compared with women with an interpregnancy interval of 6-12 months, women who conceived again within six months and went on to have a live birth in the second pregnancy were less likely to have a caesarean section (0.90, 0.83 to 0.98), preterm delivery (0.89, 0.81 to 0.98), or infant of low birth weight (0.84, 0.71 to 0.89) but were more likely to have an induced labour (1.08, 1.02 to 1.23). Conclusions Women who conceive within six months of an initial miscarriage have the best reproductive outcomes and lowest complication rates in a subsequent pregnancy.

AB - Objective To determine the optimum interpregnancy interval after miscarriage in a first recorded pregnancy. Design Population based retrospective cohort study. Setting Scottish hospitals between 1981 and 2000. Participants 30 937 women who had a miscarriage in their first recorded pregnancy and subsequently became pregnant. Main outcome measures The primary end point was miscarriage, live birth, termination, stillbirth, or ectopic pregnancy in the second pregnancy. Secondary outcomes were rates of caesarean section and preterm delivery, low birthweight infants, pre-eclampsia, placenta praevia, placental abruption, and induced labour in the second pregnancy. Results Compared with women with an interpregnancy interval of 6-12 months, those who conceived again within six months were less likely to have another miscarriage (adjusted odds ratio 0.66, 95% confidence interval 0.57 to 0.77), termination (0.43, 0.33 to 0.57), or ectopic pregnancy (0.48, 0.34 to 0.69). Women with an interpregnancy interval of more than 24 months were more likely to have an ectopic second pregnancy (1.97, 1.42 to 2.72) or termination (2.40, 1.91 to 3.01). Compared with women with an interpregnancy interval of 6-12 months, women who conceived again within six months and went on to have a live birth in the second pregnancy were less likely to have a caesarean section (0.90, 0.83 to 0.98), preterm delivery (0.89, 0.81 to 0.98), or infant of low birth weight (0.84, 0.71 to 0.89) but were more likely to have an induced labour (1.08, 1.02 to 1.23). Conclusions Women who conceive within six months of an initial miscarriage have the best reproductive outcomes and lowest complication rates in a subsequent pregnancy.

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