Quick pregnancy safe after stillbirth, study finds
28 February 2019
There is no reason to delay having another baby after a stillbirth, research in the Lancet suggests.
Although women are often told to wait for a year before getting pregnant again, there is little evidence to back up this advice.
This international study of 14,000 births found no increased risk of problems if conception happened earlier.
A UK stillbirth expert said the findings were important and reassuring.
About one in every 225 births in the UK ends in stillbirth, which is defined as the death of a baby after 24 weeks of pregnancy in the UK. However, in this study, a stillbirth is defined as a baby's death after 22 weeks' pregnancy.
Stillbirth rates have been gradually reducing in the UK since 2000, and more sharply since 2015, but compared with many other European countries, improvements in the UK have been slow.
In many countries there is limited guidance available on planning future pregnancies after stillbirth, the study says.
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Manchester University's Prof Alex Heazell, spokesman for Tommy's stillbirth charity and the Royal College of Obstetrics and Gynaecology, said his message to women was "not to worry".
"As long as they get all the information about why their baby died, then the choice of when to have another baby is down to when they are psychologically ready."
He said there was no physiological reason to wait more than a year before trying for another baby.
"Stress may exacerbate things and so waiting until that goes may be a reason for some to hold off," Prof Heazell said.
To wait or not
The researchers looked at the birth records of 14,452 women who had previously had a stillbirth in Western Australia, Finland and Norway over 37 years.
A total of 2% of those subsequent pregnancies ended in stillbirth, 18% were preterm births and 9% were babies born small for their age.
The study found that those who conceived within 12 months of stillbirth were no more likely to have another stillbirth, or a preterm birth, than women who left two or more years between pregnancies,
Out of the births studied, 9,109 or 63% were conceived within 12 months of the stillbirth.
The study, led by Dr Annette Regan, from Curtin University in Australia, said the findings were useful for clinicians who give counselling after stillbirths.
She said women who did not leave enough time to recover after a previous pregnancy could be at risk of "poor nutritional status, which has been linked to increased risk of foetal growth restriction and birth defects".
But she said this may be less likely to occur after a pregnancy loss, such as stillbirth or miscarriage.
Commenting on the research, Mark A Klebanoff, from the Research Institute at Nationwide Children's Hospital in the US, said there were other factors to consider.
"Rather than adhering to hard and fast rules, clinical recommendations should consider a woman's current health status, her current age in conjunction with her desires regarding child spacing and ultimate family size, and particularly following a loss, her emotional readiness to become pregnant again."
What is stillbirth?
- A stillbirth is when a baby is born dead after 24 completed weeks of pregnancy
- If the baby dies before 24 completed weeks, it is known as a miscarriage or late foetal loss
- Some stillbirths are linked to complications with the placenta, a birth defect or with the mother's health. For others, no cause is found
