PLoS Medicine: Guidelines for challenging abortion or post-abortion pregnancy spacing

According to a new study published Nov.
22, pregnancy within three months of miscarriage or induced abortion was not associated with an increased risk of adverse pregnancy outcomes in the ^open-access journal PLoS Medicine.
The study suggests that, contrary to current recommendations, women can try to conceive after a previous miscarriage or abortion without increasing perinatal risk and reassure those who want to try again within the time recommended by the guidelines
.

The World Health Organization recommends restarting pregnancy at six months after a miscarriage or miscarriage to avoid complications in your next pregnancy, but there is little
evidence for this.
Gizachew Tessema and colleagues from the Curtin Institute of Population Health in Australia conducted a cohort study in which there were 49,058 babies born after miscarriage and 23,707 babies born after miscarriage in Norway between 2008 and 2016
.
They looked at six adverse outcomes: preterm birth, spontaneous preterm birth, small gestational age, large gestational age, preeclampsia, and gestational diabetes
.

Babies less than 6 months pregnant have a lower risk of developing a small gestational age compared to waiting 6-11 months after abortion, and women less than 3 months pregnant have a lower
risk of gestational diabetes.
After miscarriage, the risk of small-gestational-age pregnancy less than 3 months was slightly but not significantly increased compared with 6 to 11 months, but the risk of large-gestational-age pregnancy was lower
in the 3-5 months explained interval group.

There was no evidence that the risk of adverse pregnancy outcomes was higher in women with IPI greater than 12 months after miscarriage or induced abortion, except for a slightly increased
risk of gestational diabetes.
The authors acknowledge that the study is limited because it lacks information on potential confounding factors, including pregnancy intentions and health-seeking behaviors
.
In addition, the data only included miscarriages
recorded through the healthcare system.

The findings do not support the current guidelines for abortion or waiting six months after abortion and suggest the need to review these guidelines and provide up-to-date, evidence-based recommendations
for women.

"Based on this and other studies, we call for a review
of existing WHO recommendations on pregnancy spacing," the authors added.