How long to wait after a miscarriage?

Pregnancy: no long wait after a miscarriage? According to a new study, even waiting longer can on average increase the risk of miscarriage.

(07.08.2010) Many gynecologists advise women after a miscarriage (abortion) to wait a long time before the next pregnancy. However, doctors' opinions on waiting times are divided. The reasons for a miscarriage are also different. Scottish scientists have now investigated the different waiting times until the next pregnancy and have come to astonishing conclusions. Longer waiting times until the next pregnancy could even have an adverse effect on the further course.

Miscarriages are divided into early abortions (up to the 12th week of pregnancy) and late abortions, with early abortions occurring much more often. After a miscarriage, most "wish parents" do not want to give up and try again. However, many couples are unsettled as to whether it should take a long time before trying again. The information provided by gynecologists is usually poor, and most advise you to wait a long time before your next pregnancy. Scientists from the Scottish University of Aberdeen investigated in which time frames abortions occurred and which pregnancies were successful.

In the study, the researchers focused on the question of how long waiting times affect. In the course of the study, the course of pregnancy of around 30,000 women was examined. All women had gone to a Scottish clinic because of a miscarriage. The data was evaluated between 1980 and 2000.

First, the study authors found that women who have had a miscarriage have an increased risk of having another abortion. However, the evaluation also showed that the maximum period of half a year until a new pregnancy has a positive effect on the further course of pregnancy. On average, women had miscarriages less often than women who waited longer than six months. The risk decreased overall for a second exit, abortion or an abdominal pregnancy. The risk also decreased overall by 34 percent for caesarean sections, premature births or a low birth weight. The need for an early termination of pregnancy (minus 57 percent) and the risk of ectopic pregnancy (minus 52 percent) were reduced. Both risks increased with an interval of more than 24 months.

In western industrialized countries, women have a child later and later. Overall, this has an unfavorable effect on the course of pregnancy. The study author Sohinee Bhattacharya explained that it is generally problematic to postpone pregnancy into old age. Many women in the western world only have their first child at the age of 35. This fact alone increases the risk of abortion. Because with increasing age, the likelihood of complications during pregnancy increases. From this fact alone, any further delay means a higher risk of having another abortion.

The World Health Organization (WHO) still recommends a minimum waiting period of six months. Due to social change and the results of the study, this recommendation would have to be reconsidered. Bhattacharya explained that a revised recommendation should only apply to the western world, as the study examined the course of pregnancy in Scottish women. In third world countries, the same study could possibly lead to different results. The study appeared in the "British Medical Journal" (BMJ 2010; 341: c3967). (sb)

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