Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon.
Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.
Am J Perinatol. 2024 May;41(S 01):e1599-e1605. doi: 10.1055/a-2053-8189. Epub 2023 Mar 14.
Although guidelines exist regarding optimal interpregnancy interval (IPI) after live birth, both optimal IPI and counseling regarding recommended IPI (rIPI) after stillbirth or neonatal death is not well established. Our goal was to describe the counseling bereaved parents receive regarding IPI, parents' reactions to that counseling, and actual IPI after loss.
Bereaved parents who had a previous pregnancy result in stillbirth or neonatal death participated in a web-based survey. Questions included demographics, details of stillbirth or neonatal death, IPI counseling, and pregnancy after loss. Demographic information, rIPI, and ac'tual IPI were reported using descriptive statistics. The Wilcoxon's rank sum test was used to test the association between rIPI and mode of delivery. The Spearman's correlation was used to test the association between rIPI and maternal age.
A total of 275 surveys were analyzed. Mean gestational age of stillbirth delivery was 33.1 (standard deviation: 6.6) weeks. A total of 29% delivered via cesarean. Median rIPI was 6 (interquartile ratio [IQR]: 2-9) months, with the primary reason for IPI reported as the need to heal (74%). Delivery via cesarean was associated with longer rIPI, 9 versus 4.2 months ( < 0.0001). Maternal age was not associated with rIPI. Of 144 people who pursued pregnancy again, median time until attempting conception was 3.5 (IQR: 2-6) months. Median actual IPI was 6 (IQR: 4-10) months.
Bereaved parents receive a wide range of counseling regarding rIPI. The majority receive rIPI and pursue actual IPI shorter than current national and international recommendations for optimal IPI.
· There is variation in IPI recommendation after stillbirth/neonatal death.. · Cesarean birth is associated with longer IPI recommendation, but maternal age is not.. · Median IPI after stillbirth or neonatal death was short: 6 (IQR: 4-10) months..
尽管有关活产后最佳妊娠间隔（interpregnancy interval，IPI）的指南已经存在，但仍未明确最佳 IPI 以及死产或新生儿死亡后推荐 IPI（recommended IPI，rIPI）的咨询。我们的目标是描述向丧子父母提供的 IPI 咨询内容、父母对此类咨询的反应，以及失落后的实际 IPI。
参与本项基于网络的调查的丧子父母先前有过死产或新生儿死亡的妊娠。调查问题包括人口统计学、死产或新生儿死亡的详细信息、IPI 咨询情况以及妊娠后情况。采用描述性统计报告人口统计学信息、rIPI 和实际 IPI。采用 Wilcoxon 秩和检验检验 rIPI 与分娩方式之间的关联，采用 Spearman 相关系数检验 rIPI 与产妇年龄之间的关联。
共分析了 275 份调查问卷。死产分娩的平均胎龄为 33.1（标准差：6.6）周，29%的孕妇行剖宫产分娩。中位数 rIPI 为 6（四分位距[interquartile ratio，IQR]：2-9）个月，报告的 IPI 主要原因是需要恢复（74%）。剖宫产与更长的 rIPI 相关，9 个月比 4.2 个月（<0.0001）。产妇年龄与 rIPI 无关。在 144 名再次尝试妊娠的人中，尝试妊娠前的中位时间为 3.5（IQR：2-6）个月，实际 IPI 的中位数为 6（IQR：4-10）个月。
丧子父母接受了广泛的 rIPI 咨询。大多数父母接受了 rIPI 咨询，并在实际 IPI 上短于当前国内外关于最佳 IPI 的建议。
· 死产/新生儿死亡后 IPI 推荐存在差异。· 剖宫产与更长的 IPI 推荐相关，但与产妇年龄无关。· 死产或新生儿死亡后的中位 IPI 较短：6（IQR：4-10）个月。
