Monday, January 16, 2017

Shorter Interpregnancy interval after termination of pregnancy ups the risk of preterm delivery in subsequent pregnancy.

Courtesy: www.americannursetoday.com

Women who conceive within 6 months of termination of pregnancy have a small but significant increased chance of having a preterm birth, per a recent paper published online January 09, 2017 in Obstetrics and Gynecology journal. [1]

On the other hand, longer interpregnancy interval of 18-24 months is not associated with having preterm birth, low birth weight (LBW), and small-for gestational-age (SGA) infants in the next pregnancy.

The time elapsed since last pregnancy may be one of the many factors that affects the fate of the current pregnancy. The optimum interpregnancy interval (IPI) following a delivery or miscarriage to avoid adverse pregnancy outcome has always been debated. Both longer and shorter IPI have been associated with adverse pregnancy outcome. IPI interval can be modified by women to improve the pregnancy outcome. But, to determine the role played by IPI as a single modifiable factor in pregnancy outcome is a difficult task because of multiple confounding factors.

The WHO has recommended avoiding pregnancy for 6 months after a miscarriage for a good pregnancy outcome in next pregnancy. [2]

In this register based national study carried out in Finland all women who had a termination of pregnancy (medical or surgical), between 2000 and 2009 and who had a subsequent live birth were included in the study. After excluding data on women who did not fit the study protocol, a total of 19,894 women were included in the study.

The women were divided into 5 groups based on the interval between termination and subsequent conception ending in live birth: less than 6months, 6 to less than 12 months, 12 to less than 18 months, 18 to less than 24 months and more than 24months. The group 18 to less than 24 months was taken as reference group.

Logistic regression analysis performed using SPSS 23.0 taking into account 9 demographic confounding factors like parity, prepregnancy body mass index (BMI), cohabitation, type of residence, socioeconomic status, maternal age, smoking, type of termination of pregnancy, and gestational age at termination of pregnancy.

The median interpregnancy interval was 21 months in the study group, 15% (n=52,956) of women conceived within 6 months of the termination while nearly half (45.4%) of the cohort were able to keep the interval at more than 24 months (n=59,036). 10% of the women kept the interval between 18 to 24 months and acted as reference group for the analysis.

167 (5.6%)women with an interpregnancy interval of less than 6 months had preterm delivery as compared to 83 (4.0%) in the reference group, which was statistically significant (P=.008).

The odds of woman having a preterm birth because of short interpregnancy interval was 1.44 (P=.034) as compared to control group after adjusting for all the confounding factors.

In a subgroup analysis excluding women who terminated their pregnancies because of a fetal anomaly or abnormality, the association still persisted.

Less than 6 months Interpregnancy interval did not have any effect on increased incidence of low birthweight or small for gestational age babies that remained more or less same throughout the 5 groups.

The limitation of the study is no distinction was made between spontaneous miscarriages and medical termination of pregnancy.  Ethnicity and previous H/O preterm birth could have confounded the results.

The authors concluded “Our results highlight the importance of contraception after termination of pregnancy, well-timed subsequent pregnancy may help to avoid complications associated with preterm birth.”

They stress upon the need for patient education and information of all women undergoing spontaneous or medical termination of pregnancy regarding the interpregnancy interval and risk of preterm births in subsequent pregnancies.

The full text of the article can be found here.



[1] http://journals.lww.com/greenjournal/Abstract/publishahead/Interpregnancy_Interval_After_Termination_of.98502.aspx
[2]http://www.who.int/reproductivehealth/publications/family_planning/WHO_RHR_07_1/ en/.

20 comments:

  1. This comment has been removed by a blog administrator.

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    Replies
    1. God bless Dr.CHUKWU MADU for his wonderful work in my life, my name is Helen from USA, I was diagnosed of HERPES since 2016 and it has affected my life i was
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      0936239, DOCTOR CHUKWU MADU CAN AS WELL CURE THE FOLLOWING DISEASE:- 1. HIV/AIDS 2. HERPES 3. CANCER 4. ALS 5. Hepatitis B AND C 6. Diabetes 7. Athrux, 8. hydrophobia 9.hpv 10 pregnancy spell and bring back your ex back 11 scabies 12. STD. 13.Kidney stone?

      Delete
  7. I Want To Appreciate Dr.OYAGU for hs great deeds, I Was Diagnosed With type 2 Herpes Virus Last year,And Was Look For Solution To Be Cured Luckily I Saw Testimonies On How Dr.OYAGU Cure Herpes Virus I Decided To Contact Dr.OYAGU I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I No That There Are So Many People That Have There Same Herpes Virus Please contact Dr OYAGU To Help You Too,And Help Me To Thank Dr.OYAGU For Cure Me, I’m Cured By Dr. OYAGU Herbal Medicine,His Contact Email:oyaguspellcaster@gmail.com

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    ReplyDelete
  10. I am so happy, i never believe i will be this happy again in life, I was working as an air-hoster ( cabby crew ) for 3years but early this year, i loose my job because of this deadly disease called Herpes virus (HSV), I never felt sick or have any symptom, till all workers were ask to bring their doctors report, that was how i got tested and i found out that am HSV positive that make me loose my job, because it was consider as an STD and is incurable disease, i was so depress was thinking of committing suicide, till i explain to a friend of mine, who always said to me a problem share is a problem solved, that was how she directed me to Dr Isibor, that was how i contacted him and get the medication from this doctor and i got cured for real, I just went back to my work and they also carry out the test to be real sure and i was negative. Please contact this doctor if you are herpes positive  diseases his email is: drisiborspellhome@gmail.com 
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    ReplyDelete
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    ReplyDelete
  12. i visited different hospital but they gave me list of expensive drugs to treat the symptoms and never cured me. A closed friend of mine introduce me to a Herbal Doctor who cured her. I was scared to contact him because of what i experienced from fake doctors. she encouraged me and gave me his whatsapp contact,and i contacted him and i asked him series of questions, i also ask him to show me the results of those he have cured with his herbal drugs,and he gave me all the information i needed that gave me hope. He send a Herbal medicine to me that i took and it seriously worked for me. am now Hepatitis negative. God bless you for being a sincere and great man. Am so excited and am free from herpes virus. you can reach him via email;dralikaherbalhome@gmail.com or whats-app/call on +2348116570358.

    ReplyDelete
  13. God bless Dr.CHUKWU MADU for his wonderful work in my life, my name is Helen from USA, I was diagnosed of HERPES since 2016 and it has affected my life i was
    taking my medications, I wasn't satisfied i needed to get the HERPES out of my system, I searched about some possible cure for HERPES i saw a comment about Dr CHUKWU MADU HERBALHOME how he cured HERPES with his herbal medicine, I contacted him and he guided me. I asked for solutions, he started the remedy for my health, he sent me the medicine through UPS delivery company. I took the medicine as prescribed by him and 11 days later i tested negative for HERPES, Dr.CHUKWU MADU truly you are great,It's Good for herpes patient to please read my testimony becuase People think herpes is really a minor skin irritation,herpes has a long term effects on health and The stigma attached to this virus by ignorant people is ridiculous. do you need his help also? Why don't you contact him through his email (dr.chukwumaduherbalhome@gmail.com) or call him on +234703
    0936239, DOCTOR CHUKWU MADU CAN AS WELL CURE THE FOLLOWING DISEASE:- 1. HIV/AIDS 2. HERPES 3. CANCER 4. ALS 5. Hepatitis B AND C 6. Diabetes 7. Athrux, 8. hydrophobia 9.hpv 10 pregnancy spell and bring back your ex back 11 scabies 12. STD. 13.Kidney stone?

    ReplyDelete
  14. I am so happy, i never believe i will be this happy again in life, I was working as an air-hoster ( cabby crew ) for 3years but early this year, i loose my job because of this deadly disease called Herpes virus (HSV), I never felt sick or have any symptom, till all workers were ask to bring their doctors report, that was how i got tested and i found out that am HSV positive that make me loose my job, because it was consider as an STD and is incurable disease, i was so depress was thinking of committing suicide, till i explain to a friend of mine, who always said to me a problem share is a problem solved, that was how she directed me to Dr Isibor, that was how i contacted him and get the medication from this doctor and i got cured for real, I just went back to my work and they also carry out the test to be real sure and i was negative. Please contact this doctor if you are herpes positive  diseases his email is: drisiborspellhome@gmail.com 
    or his WhatApp contact +2348110493039

    ReplyDelete
  15. herpes is a serious and recurring disease which can't be cured through drugs or injections by the American doctors but the best way to deal with herpes is by taking natural herbs medicine for it and is only few American doctors that know about this herbal medicine from Dr Akhanene .. I have read about Dr Akhanene the great herbalist doctor from African who can cure disease with his powerful herbal medicine. for the people suffering from the following diseases, Herpes, Cancer, Also,Herpatitis, Diabetes, Hps,Infections ETC should contact him for his herbal medicine because i am a living testimony and i was cured of herpes. Although, i sent him what he requested and he sent me his medicine which i took for 1 weeks and today when i went for test i was tested herpes negative. you can reach him through his Emai drakhanenespellhome@gmail.com.com or whatsapp or call him +2348168714427  

    ReplyDelete
  16. I want to use this opportunity to thank Dr Oyagu for the grate work he has done for me and my cousin sister, I was cured from herpes virus through his herbal remedy and my cousin sisters was also cured from Cancer. This is a grate testimony for what Dr Oyagu Has done for me and my entire generation. I'm giving this testimony so that those of you out there can contact him while he keeps saving my relatives. Send him a Dm and get a better health totally. Contact him via WhatsApp +2348101755322 or Email address:oyaguherbalhome@gmail.com you can also reach him on his website https://oyaguspellcaster.wixsite.com/oyaguherbalhome

    ReplyDelete
  17. I want to use this opportunity to thank Dr Oyagu for the grate work he has done for me and my cousin sister, I was cured from herpes virus through his herbal remedy and my cousin sisters was also cured from Cancer. This is a grate testimony for what Dr Oyagu Has done for me and my entire generation. I'm giving this testimony so that those of you out there can contact him while he keeps saving my relatives. Send him a Dm and get a better health totally. Contact him via WhatsApp +2348101755322 or Email address:oyaguherbalhome@gmail.com you can also reach him on his website https://oyaguspellcaster.wixsite.com/oyaguherbalhome

    ReplyDelete
  18. If you are reading this and you are suffering from HSV or any other disease or you want to fix your broken marriage/relationship or maybe get back with your Ex husband, Ex wife, Boyfriend or girlfriend.. thanks to__________________ [Robinson.buckler@] yahoo. com

    ReplyDelete