By: Laurie Edwards for Uterus1
For women thinking about having a second child, timing is everything. By spacing their pregnancies at least 18 months after their first birth and no more than five years later, experts found that women can increase their chances of having a healthy baby.
|Planning Healthy Pregnancies|
Having a subsequent birth less than 18 months after the first birth increases complications since women’s bodies may not have time to replenish nutrients and recover from the stress of birth.
For women who wait longer than five years to have another baby, decreased reproductive capacity could lead to problematic fetal development.
The CDC (Centers for Disease Control and Prevention) recommend taking certain precautions before pregnancy:
Take folic acid supplements.
Refrain from smoking.
Maintain a healthy weight.
Keep chronic conditions such as asthma and diabetes under control.
After analyzing 67 international studies that included more than 11 million pregnancies, researchers concluded that when women space births too close together or too far apart they raise the risk of such complications as low birth weight or delivering their babies prematurely.
“These data suggest that spacing pregnancies appropriately could help prevent such adverse prenatal outcomes,” the study authors wrote. Their meta-analysis was published in an April issue of the Journal of the American Medical Association.
For each month under 18 months between pregnancies, the premature birth risk increased 1.9 percent. On the other hand, for each month longer than 59 months between births, there was a 0.6 percent increased risk of premature birth.
So why do short and long intervals between pregnancies pose such problems? According to study author Dr. Agustin Conde-Agudelo, the answer isn’t totally clear yet, but there are a few viable explanations.
One such explanation is the maternal nutrition hypothesis. What this means is that when pregnancies are too close together, the mother doesn’t have the time she needs to recover from the stresses of the first pregnancy. Since pregnancy and nursing use up vital nutrients, the woman must have time to replenish them.
Another factor in short interval pregnancy could be folate depletion, which begins near the start of the fifth month of pregnancy and can cause neural tube defects and other negative outcomes for the baby.
For women who wait more than five years (or 59 months) to have another child, the risk of complications could increase because over time, a woman’s reproductive capacity decreases and impaired fertility could lead to problems with fetal development.
Given that the studies used in this meta-analysis included women from all over the world with varying levels of economic stability, education and healthcare, it would seem reasonable to attribute at least some of these results to lifestyle and socioeconomic factors. But, researchers found that even when factors like age and socioeconomic status were controlled and accounted for, the results remained the same.
There are, however, some factors like sexually transmitted diseases and maternal illnesses that could also play a role in these outcomes.
What all these results mean for women and physicians alike is that with appropriate family planning, millions of infant deaths could potentially be avoided.
This research “could be used by reproductive clinicians around the world to advise women on the benefits of delaying a subsequent pregnancy for approximately two to five years to improve the health of both mother and the next infant,” said Dr. Conde-Agudelo.
Since different nations have different attitudes towards pregnancy and nursing – for example, breast feeding exclusively for the first six months delays menstruation and could provide more time for mother and baby to improve their nutrition – planning policies may need to be tailored for specific populations’ needs.