Conception after miscarriage is safe even earlier than was thought

Conception within three months after miscarriage or abortion is not associated with an increased risk of adverse pregnancy outcomes

Maria Zavialova

Women can plan a conception after a previous miscarriage or induced abortion without increased perinatal risk. These are the results of a new study, that refutes the current recommendations,

Current recommendations for conception

According to the World Health Organization (WHO), it is necessary to wait at least six months after a miscarriage or abortion before getting pregnant again. It was believed that this period is necessary to prevent perinatal complications during the next pregnancy. Conceiving too early could cause problems such as low birth weight, gestational diabetes, etc.

What the scientists investigated

Gizachew A. Tessema from the Curtin School of Population Health, Australia, and her colleagues conducted a cohort study. It covered 49,058 births after miscarriages and 23,707 births after abortions in Norway between 2008 and 2016. They looked at six adverse outcomes. Among them are preterm birth, spontaneous preterm birth, preeclampsia and gestational diabetes. They also looked at low birth weight for gestational age, high birth weight for gestational age.

In the adjusted model we included maternal age, pregnancy and year of birth measured during the interval between pregnancies. In sensitivity analysis, we further adjusted for body mass index before smoking during pregnancy and before pregnancy.

Study authors

Results of the study

Contrary to current recommendations, the researchers found that women who conceived less than six months later had a lower risk of having low birth weight babies. The risk of gestational diabetes in women who conceived less than three months after a miscarriage or abortion was lower. After abortion, there was a slight, but not significant, increase in the risk of having a low birth weight baby if conceived at less than three months compared to 6-11 months. However, the risk of having a high birth weight baby was lower in the group with an interval between pregnancies of 3-5 months.

There was also no evidence of an increased risk of adverse pregnancy outcomes in women with an interval of more than 12 months after miscarriage or induced abortion. Only a moderately increased risk of gestational diabetes was observed.

The authors admit that the study was limited because it lacked information about potential confounders. These include intention to become pregnant and seeking medical care. In addition, the data included only miscarriages registered in the health care system.

Conclusions of the researchers and recommendations for conception

The findings do not support current recommendations to wait six months after a miscarriage or abortion. The authors point to the need to revise these recommendations and provide up-to-date, evidence-based guidance for women.

Combined with previous studies, our results are encouraging for families trying to conceive soon after a miscarriage or induced abortion. These findings prompt a review of current international recommendations for birth spacing after miscarriage or induced abortion.

Study authors

Good news.

You can find comprehensive recommendations on your steps before conceiving a child in the School of Women’s Health course Preparing for Pregnancy. Thorough instructions on pregnancy, childbirth and the first year of the baby’s life are contained in the course Pregnancy and postpartum – a complete guide.

I’m eager to file all of these courses in English, just send me a request to dr.silinaeducation@gmail.com

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