Have a Three Month Old Baby and Pregnant Again
For older mothers, it tin can experience like there'due south little fourth dimension to waste material earlier trying for another child. But there are real risks linked to getting pregnant again besides before long. Lauren Bates/Getty Images hide caption
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Lauren Bates/Getty Images
For older mothers, it can feel like there's little time to waste before trying for another child. But there are real risks linked to getting significant over again likewise soon.
Lauren Bates/Getty Images
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Many older get-go-time moms face up a dilemma when it comes to baby No. 2. The clock is ticking louder than ever. But doctors advise waiting at to the lowest degree a year and a half after giving nascency before conceiving over again.
This is the standard communication, based on multiple studies and public health guidelines. But deciding when to try again can exist a difficult decision — weighing medical chance against infertility risk. Now there are some new data points to factor in. A paper published Monday in the journal JAMA Internal Medicine analyzed medical records from nearly 150,000 Canadian pregnancies to tease out how a female parent's age influences the effects of a shorter-than-recommended interval between pregnancies.
For older moms in a bustle, the bad news is that the study adds evidence that conceiving inside 12 months of a birth does mean heightened health risks for both mother and child. But epidemiologist Laura Schummers, who led the research while at Harvard and is at present a postal service-doctoral fellow at the Academy of British Columbia, says at that place's good news for y'all here too:
"The optimal spacing window that nosotros found was one to two years afterward the commitment of 1 child until the formulation of the adjacent pregnancy," she says. "That'due south when we institute the lowest risk for both mothers and babies." And, she adds, that's short compared to some previous studies that had suggested the optimal wait was between 18 months and up to v years.
By enquiry has institute a clear link between short "interpregnancy intervals" and increased take chances of health problems for mother and baby, including premature birth. But why? The debate, Schummers says, revolves effectually whether the short interval is a direct biological cause of the risks, or whether information technology it is itself a result of other forces at work in the female parent's life — for instance, a lack of access to wellness care and unintended pregnancies.
Considering older women are likelier to plan their pregnancies and have better access to care, Schummers and colleagues hypothesized that those mothers would not incur as much hazard as younger women practise if they had babies close together.
They found out they were wrong.
"In fact," Schummers says, "we found that at that place were risks of adverse babe outcomes for women of all ages.
"The risks to the babies were higher amid younger women, which was consistent with the squad'south hypothesis. But risks to the mothers were higher among older women — indeed, but older mothers incurred higher risks to their own health past getting pregnant again and so presently.
After accounting for other factors that could bulldoze these numbers, Schummers says, the stats milk shake out like this:
• For women 35 years or older who conceived just six months after a nascency, 6.2 per thousand experienced serious disease or injury, including death. Wait 18 months and that adventure dropped to 2.half dozen per per chiliad. So, small absolute numbers but a dramatic deviation.
• A "severe agin babe effect" includes stillbirth and being built-in very early or very pocket-size. Amid women ages xx to 34, those who conceived after just half-dozen months had xx babies per g with those severe outcomes; the risk drops to 14 per one thousand amidst those who waited 18 months.
• Amidst women 35 years or older, there were 21 astringent infant outcomes per thousand amid those who waited only six months; the take chances drops to 18 per thousand among those who waited eighteen months.
"This shows you lot both the relationship between pregnancy spacing and the increased risk," Schummers says, "but also that older women tend to take a higher baseline risk of many of these outcomes at all pregnancy spacing lengths."
The inquiry turned up a similar pattern for premature birth: A short pregnancy interval raises the adventure for all women, but peculiarly for younger women. The risk for them dropped from 53 per thousand at a six-calendar month interval to 32 per m at an 18-calendar month interval. For women over 35, the risk dropped from 50 per thousand at six months to 36 per thousand later 18 months.
It seems like common sense that a woman's trunk may need more vi months to fully recover from building a babe and giving nativity, but the actual mechanism backside the risks of brusk pregnancy intervals is not fully articulate.
The leading theory, Schummers says, is that nutrients like iron or folate could exist depleted in the mother's body. Just more research is needed to come across if that theory holds in developed countries like the United states of america and Canada, or if in that location are other mechanisms that accept non yet been identified.
For now, she says, her squad hopes these new findings can help women make decisions within their own personal contexts, and in consultation with their medical teams. The data may exist particularly helpful for older women, she says, because they more often decide to have short pregnancy intervals on purpose.
"And then if you're making that kind of determination on purpose," she says, "it'south easier to say, 'You know, let's wait some other 3 months.' "
Source: https://www.npr.org/sections/health-shots/2018/11/01/663181674/how-long-should-older-moms-wait-before-getting-pregnant-again
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