Adverse pregnancy outcomes, such as a miscarriage, stillbirth or neonatal death (death within the first 30 days of infancy), are more likely when preceded by an outcome of the same type in combination with a short interval between outcomes, a new study finds. The study was led by researchers from the International Center for Maternal and Newborn Health (ICMNH) at the Johns Hopkins Bloomberg School of Public Health.
The study, published in February by BMC Pregnancy and Childbirth, used self-reported data from mothers in the Projahnmo I study in rural Bangladesh. Projahnmo I is a community-based study in the Sylhet district of Bangladesh aimed at evaluating the effects of an integrative maternal and newborn care program on neonatal mortality.
Across all intervals, negative outcomes were more likely when preceded by an outcome of the same type, whether it be miscarriage, stillbirth or neonatal death, the study found. Inter-outcome intervals (IOI) of less than 6 months and 7–14 months were associated with an increased risk of an adverse outcome, as compared to IOIs of 27–50 months. The data suggest that in rural northeast Bangladesh, the 6-month pregnancy interval following any of 3 adverse events was associated with the highest risk of a miscarriage in the next pregnancy.
“This is an important contribution to the literature because there is a paucity of data on this subject from settings with poor health care services. Even though birth-spacing patterns have improved in general, some areas are still lagging behind,” says Dr. Bareng Nonyane, lead author of the study and associate scientist in the Bloomberg School’s department of international health.Friday Letter Submission