Women can maximize their
chances of having healthy babies by spacing their
pregnancies at least 18 months but no more than
five years apart, researchers say.
The researchers reached that conclusion after
an analysis of 67 international studies involving
more than 11 million pregnancies.
The analysis found that spacing babies too close
together or too far apart raises the risk of complications
such as premature births and low birth weight.
The findings suggest that millions of infant deaths
could be avoided worldwide with better family planning,
said co-author Dr. Agustin Conde-Agudelo of Santa
Fe de Bogota Foundation in Colombia.
"The financial cost of birth spacing programs is
lower than the financial cost of infant deaths,
of course," Conde-Agudelo said in an e-mail.
Pregnancy and nursing use up nutrients in a woman's
body, he said, and for a woman to get pregnant again
before she has a chance to recover nutritionally
may mean higher risks for the baby.
As for why long intervals between births cause
problems too, he speculated that time could diminish
a woman's reproductive capacity and that factors
that decrease fertility also could lead to poor
fetal development.
The analysis found that for each month under 18
months between pregnancies, the risk of premature
birth increased 1.9 percent. For each month longer
than 59 months between pregnancies, the chances
of premature birth climbed 0.6 percent.
The analysis appears in Wednesday's
Journal of the American Medical Association.
Conde-Agudelo said the risks of short and long
birth intervals held true for both developing and
developed nations, showing up in U.S. studies and
in research from Europe, Africa and Latin America.
The World Health Organization
should consider recommending longer intervals between
births, said Rachel Royce, an epidemiologist at
Research Triangle Institute International in North
Carolina who wrote an accompanying editorial in
the journal.
Dr. Sarah Kilpatrick of the University of Illinois-Chicago,
who was not involved in the research, said doctors
should educate women about why it is better to space
their pregnancies and make sure they have access
to contraception.
"The U.S. is lucky because we have access to many
more contraceptive methods than many other countries,"
she said.
