Association between interpregnancy with a previous stillbirth: an international cohort study

on 18 June 2019

By Regan AK; Gissler M; Magnus MC; et al. The Lancet, vol 393, no 10180, 13 April 2019, pp 1527-1535

To reduce the risk of adverse birth outcomes, WHO recommends that women wait at least 2 years after a livebirth and at least 6 months after a miscarriage or induced abortion before conceiving again. Yet no recommendation currently exists for the optimal interval after a stillbirth.

Using data from birth records from Finland (1987–2016), Norway (1980–2015), and Western Australia (1980–2015), this international cohort study investigated the association between interpregnancy interval after stillbirth and birth outcomes in the subsequent pregnancy. Consecutive singleton pregnancies in women whose most recent pregnancy had ended in stillbirth of at least 22 weeks’ gestation were also included in the analysis.

The study identified 14,452 births in women who had a stillbirth in the previous pregnancy; median interpregnancy interval after stillbirth was 9 months (IQR 4–19). 9,109 (63%) women conceived within 12 months of the stillbirth. Of the 14,452 births, 228 (2%) were stillbirths, 2,532 (18%) were preterm births, and 1,284 (9%) were small-for-gestational-age births.

The study found that conception within 12 months of a stillbirth was common and was not associated with increased risk of adverse outcomes in the subsequent pregnancy. These findings could be used when counselling women who are planning future pregnancies after a stillbirth and for informing future recommendations for pregnancy spacing in a high-income setting.

The study was funded by the National Health and Medical Research Council (Australia), and Research Council of Norway. Links to the abstract and further details can be found here.

Pregnancy after stillbirth | Abstracts (56) £9.95

This month’s pre-prepared search pack features articles exploring risks and outcomes; women’s decision making; considerations to make when providing antenatal care; and mental health factors. Also features records on stillbirth recurrence.

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