Luchin F Wong1, Karen C Schliep2, Robert M Silver3, Sunni L Mumford2, Neil J Perkins2, Aijun Ye2, Noya Galai4, Jean Wactawski-Wende5, Anne M Lynch6, Janet M Townsend7, David Faraggi4, Enrique F Schisterman2. 1. Department of Obstetrics and Gynecology, University of Utah School of Medicine, and Department of Maternal-Fetal Medicine, Intermountain Healthcare, Salt Lake City, UT. Electronic address: luchin.wong@hsc.utah.edu. 2. Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. 3. Department of Obstetrics and Gynecology, University of Utah School of Medicine, and Department of Maternal-Fetal Medicine, Intermountain Healthcare, Salt Lake City, UT. 4. Department of Statistics, University of Haifa, Haifa, Israel. 5. Department of Epidemiology and Environmental Health, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY. 6. Department of Obstetrics and Gynecology, School of Medicine, University of Colorado, Denver, CO. 7. Department of Family, Community, and Rural Health, Commonwealth Medical College, Scranton, PA.
Abstract
OBJECTIVE: We sought to assess the relationship between a short interpregnancy interval (IPI) following a pregnancy loss and subsequent live birth and pregnancy outcomes. STUDY DESIGN: A secondary analysis of women enrolled in the Effects of Aspirin in Gestation and Reproduction trial with a human chorionic gonadotropin-positive pregnancy test and whose last reproductive outcome was a loss were included in this analysis (n = 677). IPI was defined as the time between last pregnancy loss and last menstrual period of the current pregnancy and categorized by 3-month intervals. Pregnancy outcomes include live birth, pregnancy loss, and any pregnancy complications. These were compared between IPI groups using multivariate relative risk estimation by Poisson regression. RESULTS: Demographic characteristics were similar between IPI groups. The mean gestational age of prior pregnancy loss was 8.6 ± 2.8 weeks. The overall live birth rate was 76.5%, with similar live birth rates between those with IPI ≤3 months as compared to IPI >3 months (adjusted relative risk [aRR], 1.07; 95% confidence interval [CI], 0.98-1.16). Rates were also similar for periimplantation loss (aRR, 0.95; 95% CI, 0.51-1.80), clinically confirmed loss (aRR, 0.75; 95% CI, 0.51-1.10), and any pregnancy complication (aRR, 0.88; 95% CI, 0.71-1.09) for those with IPI ≤3 months as compared to IPI >3 months. CONCLUSION: Live birth rates and adverse pregnancy outcomes, including pregnancy loss, were not associated with a very short IPI after a prior pregnancy loss. The traditional recommendation to wait at least 3 months after a pregnancy loss before attempting a new pregnancy may not be warranted.
OBJECTIVE: We sought to assess the relationship between a short interpregnancy interval (IPI) following a pregnancy loss and subsequent live birth and pregnancy outcomes. STUDY DESIGN: A secondary analysis of women enrolled in the Effects of Aspirin in Gestation and Reproduction trial with a human chorionic gonadotropin-positive pregnancy test and whose last reproductive outcome was a loss were included in this analysis (n = 677). IPI was defined as the time between last pregnancy loss and last menstrual period of the current pregnancy and categorized by 3-month intervals. Pregnancy outcomes include live birth, pregnancy loss, and any pregnancy complications. These were compared between IPI groups using multivariate relative risk estimation by Poisson regression. RESULTS: Demographic characteristics were similar between IPI groups. The mean gestational age of prior pregnancy loss was 8.6 ± 2.8 weeks. The overall live birth rate was 76.5%, with similar live birth rates between those with IPI ≤3 months as compared to IPI >3 months (adjusted relative risk [aRR], 1.07; 95% confidence interval [CI], 0.98-1.16). Rates were also similar for periimplantation loss (aRR, 0.95; 95% CI, 0.51-1.80), clinically confirmed loss (aRR, 0.75; 95% CI, 0.51-1.10), and any pregnancy complication (aRR, 0.88; 95% CI, 0.71-1.09) for those with IPI ≤3 months as compared to IPI >3 months. CONCLUSION: Live birth rates and adverse pregnancy outcomes, including pregnancy loss, were not associated with a very short IPI after a prior pregnancy loss. The traditional recommendation to wait at least 3 months after a pregnancy loss before attempting a new pregnancy may not be warranted.
Authors: Enrique F Schisterman; Robert M Silver; Neil J Perkins; Sunni L Mumford; Brian W Whitcomb; Joseph B Stanford; Laurie L Lesher; David Faraggi; Jean Wactawski-Wende; Richard W Browne; Janet M Townsend; Mark White; Anne M Lynch; Noya Galai Journal: Paediatr Perinat Epidemiol Date: 2013-10-11 Impact factor: 3.980
Authors: A J Wilcox; C R Weinberg; J F O'Connor; D D Baird; J P Schlatterer; R E Canfield; E G Armstrong; B C Nisula Journal: N Engl J Med Date: 1988-07-28 Impact factor: 91.245
Authors: Tal Margaliot Kalifa; Eyal Lang Ben Nun; Hen Y Sela; Fayez Khatib; Sorina Grisaru-Granovsky; Misgav Rottenstreich Journal: J Clin Med Date: 2022-05-13 Impact factor: 4.964
Authors: Karen C Schliep; Emily M Mitchell; Sunni L Mumford; Rose G Radin; Shvetha M Zarek; Lindsey Sjaarda; Enrique F Schisterman Journal: Obstet Gynecol Date: 2016-02 Impact factor: 7.661
Authors: Kristin Palmsten; Michael V Homer; Yujia Zhang; Sara Crawford; Russell S Kirby; Glenn Copeland; Christina D Chambers; Dmitry M Kissin; H Irene Su Journal: Fertil Steril Date: 2018-05 Impact factor: 7.329