April 25, 2005 Postabortion Interpregnancy Interval
 I understand adequate birthspacing is important for infant health. But after abortion, is it also advisable to wait for a time before another pregnancy?
 Yes at least 5 months, based on a new large study from Latin America. In that study, post-abortion interpregnancy intervals (PAIIs) of less than 6 months were associated with sizable increased risks of low birth weight, preterm delivery, maternal anemia and premature rupture of membranes.
Comment: Strengths of the study were - large size, developing world context including 18 countries in Latin America, and careful analysis including control for a large number of potential confounding variables. It had the limitation of not being able to distinguish spontaneous and induced abortion. Also the study was observational and thus subject to potential bias. For example, there could be ways (not addressed in the analysis) that women who get pregnant right away after an abortion are different. Or reporting of previous abortion might be affected in some way. Still the magnitude, pattern of the association and statistical significance of the findings are strong. For example, the risk of preterm birth is over twice as much for a PAII of 0-2 months than for a PAII of 12-17 months.
Significance: Women and their partners should understand that after abortion, it is probably wise to wait at least 5 months to get pregnant again in order to help prevent adverse perinatal and maternal outcomes. Importantly, it also strengthens the already-compelling need to make accessible, quality family planning services an integral part of post-abortion care (PAC).
References:
Conde-Agudelo A et al. Effect of the interpregnancy interval after an abortion on maternal and perinatal health in Latin America. In J Gyn OB. 2005;89 Suppl 1:S34-40.
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Pearl Archive
The "Pearls" offer answers to commonly asked questions about family planning. These "Pearls" are prepared by Dr. James D. Shelton, Senior Medical Scientist, Office of Population, United States Agency for International Development (USAID)
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