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Wait at least a year before conceiving another baby to minimize health risks, new study suggests

New parents planning another pregnancy should wait at least a year to conceive in order to minimize health risks to both mom and baby, according to new research.

Women who get pregnant 6 months after giving birth more prone to rare but severe complications

A photograph shows an unidentifyable person holding the hands of a newborn baby.
Most public health guidelines advise mothers to wait at least 18 months after giving birth before conceiving again, but a new study suggests a year may be long enough to minimize life-threatening risks. (Loic Venance/AFP/Getty Images)

New parents planning another pregnancy should wait at least a year to conceive in order to minimize health risks to both mom and baby, according to new research from the University of British Columbia (UBC) and the Harvard T.H. Chan School of Public Health.

Although public health agencies, including the World Health Organization, generally recommend at least 18 months to two years between pregnancies, the studypublished in the journal JAMAInternal Medicine suggests one year after birth couldbe enough time before safely conceiving again for women who are anxious to have another child as soon as possible.

"The very lowest risk time that we found was 18 months," said Laura Schummers, lead author and a postdoctoral fellow at UBC's department of family practice. "But what we found also was that risks between12 and24 months were basically equivalent to those at 18 months."

"Risks between 12 and 24 months were basically equivalent to those at 18 months," said Laura Schummers, post-doctoral fellow in the department of family practice at the University of British Columbia. (Robert Lyons/B.C. Children's Hospital )

TherisksSchummersand her team evaluated for womenareoften called "near-miss mortality" events associated with pregnancy and delivery,shesaid. "This is organ failure, intubation, or being in [the] intensive care unit.This is not ... a complication like developing preeclampsia, which is much more common."

The research team also included maternal deaths, but those are "thankfully" extremely rare in Canada, she said, so were too few to be consideredon their own.

The severe fetal and newborn risks measured includevery low birth weight,premature birth, stillbirth and infant death within one year of birth.

The researchers looked for these outcomes in records documenting148,544 pregnancies in British Columbia over 10 years, from 2004 to 2014. They also tracked the age range of the pregnant women to see if thoseage 35 and over might be at heightenedrisk.

The study found that the risk of these serious health issues for both the infant and mother was higher when women had conceived six months after previously giving birth compared to waiting at least 12 to 18 months.

'Might be worth waiting'

Among women between 20 and 34 years old who became pregnant six months after their last baby was born, 85 out of 1,000 had premature births. That risk dropped by more than half (37 cases per 1,000) when the pregnancies were spaced out by 18 months.

Although being olderdidn't increase that risk for infants any further, it did affect affect the mothers themselves. About six out of every 1,000 women age35 and older who conceived another baby six months after giving birth suffered life-threateningcomplications. That risk dropped to aboutthree in 1,000 when mothers in that age group waited at least a year.

"Afamily that might beconsidering a second pregnancy about sixor ninemonths after delivery of the first, it might be worth waiting that extra three to sixmonths to lower risks, both to the mother and baby," saidSchummers.

Rare but serious health risks associated with pregnancy spacing are one of many factors women and their partners need to consider when deciding when to conceive, says Dr. Danielle Martin, a family physician at Women's College Hospital in Toronto. (Nicole Ireland/CBC)

The study purposely separated women out into age groups, she said, because women over age 35 may feel "time pressure" to have a second child quickly as fertility decreases.

But the findings couldactually be "encouraging" for those women, Schummers said, by showing that it might not be necessary to wait for 18 months, as other health guidelines suggest, and a yearmight seem more manageable.

Dr. Danielle Martin, a family physician at Women's College Hospital in Toronto, said the study could helphealth-care providers"get a little bit more specific about,how long should women be trying to wait between giving birth and their next conception, all things being equal, if they want to minimize the health risks for themselves and their babies."

The severe risks considered by the researchers are "very rare," notedMartin, who was not involved in the study.

"A small increase in an extremely rare event is still an extremely rare event, but nevertheless it is an increase in the risk," she said. "And I think that women need to know, and their partners need to know ... that it is one of many factors that they may want to consider."

'Not every pregnancy is planned'

Those other factors could include the timing that works best for them and their families, as well as career considerations, Martin said.Women and their partners are also trying to balance the risks of having another child quickly with the risks of waiting as they continue to age.

It's also important to remember that "not every pregnancy is planned," she added. "We are always going to need to continue to try to find other ways to reduce the risk for women who do get pregnant in less than 12 months after giving birth."

"There's a lot that we don't know" about what exactly happens biologically that would make it more risky to have pregnancies less than a year apart, Martin said.

"Still much work remains to be done."

Watch this story on The National:

Study says mothers should wait at least a year between pregnancies

6 years ago
Duration 1:57
Mothers should wait at least a year between giving birth and getting pregnant again to reduce health risks to mom and baby, according to a new Canadian study.

With files from Christine Birak