Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study
Women with gaps between pregnancies of less than six months or longer than 59 months are at increased risk of complications during pregnancy, finds a study in this week's BMJ. However, as the research was carried out in developing countries, these results may not apply to other populations.
Researchers for the Pan American Health Organisation in Uruguay examined the effects of interpregnancy intervals for over 400,000 women in Latin America and the Caribbean. They found that, compared with women with intervals between pregnancies of 18 to 23 months, women with short intervals (less than 6 months) had a 2.5-fold higher risk of death, a 70% increased risk of bleeding during the later stages of pregnancy and premature rupture of membranes, and a 30% increased risk of infection and anaemia. Women with long intervals (more than 59 months) between pregnancies were more likely to develop pre-eclampsia and eclampsia.
Although the reasons for these findings are unclear, the authors suggest that short intervals between pregnancies do not allow the mother to recover from the physical stresses imposed by the previous pregnancy. Conversely, the "protective" effect for pre-eclampsia acquired by a woman through a previous birth is lost after a long interval, they add.
Despite some limitations, this study underscores the importance of birth spacing to promote safe motherhood, say the authors. They stress that, as the research was carried out in developing countries, the results may not apply to other populations.
Contact:
Agustin Conde-Agudelo, Latin American Centre for Perinatology and Human Development, Montevideo, Uruguay
Email: condeagu@uniweb.net.co