Wednesday, June 12, 2013

The optimal inter-pregnancy interval, 18-23 Months

Today I learned how long the optimal inter-pregnancy interval should be. I was previously informed that pregnancies should be spaced at least two years and I had no real opinion on the issue of having "too long" an interval in between pregnancies... I was wrong!

This discovery was prompted by a project I am working on in my Internship with REACHUP, Inc. to create educational materials for consumers about preconception and inter-conception health - like the example below!

For those who don't know, preconception and inter-conception refers to the time before (pre) and between (inter) pregnancies.





Research demonstrates (and frankly so does common sense) that your health before you get pregnant and in between your pregnancies is important to your future health and that of your future baby! Planning your family can help you accomplish important goals, get healthy before pregnancy, and make decisions that will make your future family stronger.

For example, in the case of someone who is overweight, chronically stressed, and smoking, preconception health would mean this individual improves their diet, begins a sustainable exercise program, and gets help to quit smoking - all before becoming pregnant.

But enough about preconception health, I can talk more about that later. Let's look at the research about spacing pregnancies.

In regards to the optimal inter-pregnancy interval, Zhu (2005) evaluated the results of three VERY large studies which collected data on inter-pregnancy intervals and indicators such as preterm birth, low birth weight, and small for gestational age (SGA). All three studies came to strikingly similar conclusions, the optimal inter-pregnancy interval is approximately 18-23 months.

The lowest apparent risk for outcomes such as preterm birth, low birth weight, and being small for gestational age is between 18-23 months, however, an inter-pregnancy interval from approximately 6 months - 5 years demonstrated only slightly elevated risk.

It is in the "extreme" regions of the inter-pregnancy interval that the risks increase significantly. As you can see in the graph below (from the original research article - I have included it to demonstrate the "J-curve" for increased risk in the extremes of the inter-pregnancy interval) a subsequent pregnancy within 6 months increases the risk of adverse infant outcomes. Similarly, Inter-pregnancy intervals of about 4-5 years or greater also see an increase in risk.


Simply put, having babies too close together, or spaced too far apart, increases the risk of the subsequent baby being born preterm, low birth weight, or small for gestational age.

This may be most important for women who have had a previous pre-term, low birth weight, or SGA baby. These women should especially consider ensuring an adequate inter-pregnancy interval between their babies!

There are many ways to "space" your pregnancies, some of which include natural family planning methods such as exclusive breastfeeding and tracking your ovulation. Other methods can include barrier methods such as condoms and contraception like birth control or long-acting forms such as the IUD. Contact your health provider, a local clinic, or planned parenthood for more information about birth control.



Happy Family Planning!
~Wisdom and Birth

6 comments:

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