Wait at least a year before new baby

New parents planning a new pregnancy should be at least a year old, according to new research from the University of British Columbia (UBC) and the Harvard T.H. Chan School of Public Health.

The public health agencies, including the World Health Organization, are at least 18 months to two years between pregnancies, the study published in the journal. JAMA Internal Medicine suggests a year after birth to have another child as soon as possible.

"Said Laura Schummers, lead author and postdoctoral fellow at UBC's department of family practice. "But what were the risks between 12 and 24 months were basically equivalent to 18 months."

The risks Schummers and her team are often called "near-miss mortality" events associated with pregnancy and delivery, she said. "This is organ failure, intubation, or being in [the] intensive care unit. This is 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 too few to be considered on their own.

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

The researchers looked for these outcomes in records documenting 148,544 pregnancies in British Columbia over 10 years, from 2004 to 2014. They also reported that they were more likely to be at heightened risk.

The study found that the risk of these serious health issues – for both the mother and the mother – was higher compared to 12 to 12 months.

'Might be worth waiting'

Among women between 20 and 34 years old, who became pregnant after having had their baby 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 older, it did not affect the risk for infants any further, it did affect the mothers themselves. Six months of giving birth to life-threatening complications. That risk dropped to at least a few years ago when at least a year ago.

"A family that could be considered as a second pregnancy, or both, and the mother and the baby," said Schummers.

The study can be compared to other groups, she said, because women over age 35 can feel "time pressure" to have a second child quickly as fertility decreases.

But the findings could actually be "encouraging" for those women, saying that it might not be necessary to wait for 18 months, and that it might be more manageable.

Dr. Danielle Martin, a family physician at Women's College Hospital in Toronto, said the study could help health-care providers "get a little bit more specific about things being equal, if they want to minimize the risks for themselves and their babies. "

Martin, 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, Martin said. Women and their partners are also trying to balance the risks of having a baby with the baby.

It's also important to remember that "not every pregnancy is planned," she added. "We are always going to need to get pregnant in 12 months after giving birth."

"There's a lot that we do not know," he said.

"Still much work remains to be done."

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