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When to have another pregnancy after a miscarriage

Women should try to have another pregnancy immediately after a miscarriage if they want to have a healthy baby, a new study published in the British Medical Journal suggests. 

The study found women who got pregnant within six months of a miscarriage were more likely to have a healthy pregnancy, compared to those who delayed six months or longer to conceive again.

The World Health Organization reportedly recommends that women who have a miscarriage should wait at least six months before getting pregnant again.

Sohinee Bhattacharya from the University of Aberdeen and colleagues examined data from over 30,000 women who attended Scottish hospitals for maternal care between 1981 and 2000. These women had another pregnancy after a miscarriage.

The study was meant to determine how the interpregnancy internal following a miscarriage would affect the outcome of the next pregnancy.

The researchers found women who had another pregnancy within six months of a miscarriage were at lower risk of another miscarriage, termination of pregnancy or ectopic pregnancy compared to those who became pregnant after six months.
In the study, the live birth rate was found at 85.2 percent in women who got pregnant again within six months of a miscarriage compared to 73.3 percent in those who had another pregnancy after 24 months.

In addition, women who had another pregnancy within six months were less likely to have a Cesarean section, give premature birth or have low birth weight babies compared to those who had another pregnancy six months to 12 months after a miscarriage, the study found.

The authors say that although the study involved women in Scotland and the results may not be applicable to those in developing countries, the findings suggest that women in Scotland should not wait six months to have another pregnancy.

The authors conclude: "our research shows that it is unnecessary for women to delay conception after a miscarriage."

Not all studies led to the same conclusion as the current one.

Sholapurkar S. L. at the Royal United Hospital in Bath, United Kingdom said in an early report that many studies suggest that after full term and preterm delivery, the interpregnancy interval of less than 18 months and more than 5 years after a spontaneous miscarriage was associated with elevated risk of poor perinatal and maternal outcome.

Reporting in the Feb 2010 issue of Journal of Journal of Obstetrics and Gynaecology, Sholapurkar cited one study, which he believed is of good quality, saying that the interval length between a miscarriage and the next pregnancy does not affect the pregnancy outcome when the next pregnancy occurs within 50 months of a miscarriage.

A miscarriage, also known as spontaneous abortion, is a spontaneous loss of a fetus before the 20th week of pregnancy.

One in five pregnancies end in miscarriages before 24 weeks.  And Women at the age of 35 or older are more likely to have a miscarriage. At the age 40, the rate of miscarriage is 30 percent compared to 50 percent for those aged 45 or older, according to the background information in the study by Bhattacharya et al.

Most miscarriages are caused by chromosome problems that make it impossible for the fetus to continue to develop, according to The U.S. National Library of Medicine. The problems have nothing to do with the mother or father's genes.

Other possible causes include hormone problems, infection in pregnancy, physical problems with the mother's reproductive organs, problem with the immune system and certain diseases in the mother.

Women who are at higher risk for a miscarriage are those who are 35 years of age or older and who have had previous miscarriages.

Miscarriages in some cases can be preventable.  Treatment for diseases that induce miscarriages before pregnancy can help prevent the devastating event.

Some adverse events such as exposure to x-rats drugs and alcohol, high levels of caffeine and infectious diseases should be avoided prior to or during pregnancy.

What food consumers need to know?

Vaccination in pregnancy can lead to miscarriage, according to some media reports. Dr. Joe Mercola, owner of mercola.com reported that some pregnant women who received swine flu vaccine ended up having a miscarriage.

Pregnant women's diet during pregnancy may play a significant role.  One study reported in the International Journal of Obstetrics and Gynecology suggests that eating fruits and veggies in pregnancy may reduce the risk.

Dr. Maureen Maconochie from the London School of Hygiene and Tropical Medicine and colleagues followed up thousands of pregnant women and found those eating fruits and vegetables often in pregnancy were 46 percent less likely to experience a miscarriage than those who did not use fruit and veggies as often.

Additionally, the researchers found women who used chocolate, vitamin tablets, dairy products, fish and white meat during pregnancy were also less likely to have a miscarriage.

On the other hand, women who were underweight were 70 percent more likely to have a miscarriage, and stress resulting from separation, divorce, illness and a stressful job boosted the risk by 60 percent, the authors found.

By David Liu