Effect of interpregnancy interval on outcomes of pregnancy after miscarriage: retrospective analysis of hospital episode statistics in Scotland.
OBJECTIVE
To determine the optimum interpregnancy interval after miscarriage in a first recorded pregnancy.


METHODS
Population based retrospective cohort study.


METHODS
Scottish hospitals between 1981 and 2000.


METHODS
30,937 women who had a miscarriage in their first recorded pregnancy and subsequently became pregnant.


METHODS
The primary end point was miscarriage, live birth, termination, stillbirth, or ectopic pregnancy in the second pregnancy. Secondary outcomes were rates of caesarean section and preterm delivery, low birthweight infants, pre-eclampsia, placenta praevia, placental abruption, and induced labour in the second pregnancy.


RESULTS
Compared with women with an interpregnancy interval of 6-12 months, those who conceived again within six months were less likely to have another miscarriage (adjusted odds ratio 0.66, 95% confidence interval 0.57 to 0.77), termination (0.43, 0.33 to 0.57), or ectopic pregnancy (0.48, 0.34 to 0.69). Women with an interpregnancy interval of more than 24 months were more likely to have an ectopic second pregnancy (1.97, 1.42 to 2.72) or termination (2.40, 1.91 to 3.01). Compared with women with an interpregnancy interval of 6-12 months, women who conceived again within six months and went on to have a live birth in the second pregnancy were less likely to have a caesarean section (0.90, 0.83 to 0.98), preterm delivery (0.89, 0.81 to 0.98), or infant of low birth weight (0.84, 0.71 to 0.89) but were more likely to have an induced labour (1.08, 1.02 to 1.23).


CONCLUSIONS
Women who conceive within six months of an initial miscarriage have the best reproductive outcomes and lowest complication rates in a subsequent pregnancy.
Love
Eleanor R
ER
University of Aberdeen, Aberdeen.
Bhattacharya
Siladitya
S
Smith
Norman C
NC
Bhattacharya
Sohinee
S
D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000328:Adult; D001721:Birth Intervals / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology