I am so excited to announce that I am pregnant with my second, a baby boy, due March 2022! Already a proud mom of a beautiful baby girl born in December 2020, if all goes as planned, my two little ones will be 15 months apart. Although this seems like a daunting task: wife, surgeon, and mom of two under 1.5 years ago, I have the support of my husband and family and am excited for this next phase of parenthood.
While I am fortunate to have become pregnant again so quickly, I became pregnant again at six months postpartum, which is considered a short interpregnancy interval. Let’s review what is the recommended interpregnancy interval and what are some of the risks associated with a short interval.
A short birth-to-pregnancy interval can be considered ≤6 to 18 months because ≤6 months is associated with elevated maternal risk and ≤18 months is associated with elevated perinatal risk. ACOG, or the American College of Obstetricians and Gynecologists, recommends advising women to avoid interpregnancy intervals < 6 months, where adverse outcomes are highest, and that there are modest risks and benefits of intervals <18 months.
Specifically in women who have had a cesarean delivery, like myself, delaying conception for at least 18 months following a cesarean delivery is important to allow for adequate healing of the uterine scar among women who desire a vaginal birth after cesarean. Data has shown that a shorter interpregnancy interval, specially less than 6 months, has been associated with uterine rupture during trial of labor after cesarean.
In contrast however, in regards to my history of pre eclampsia, longer interpregnancy intervals are associated with an increased risk of developing pre eclampsia. Among women with a history of preeclampsia and a subsequent pregnancy with the same partner, interpregnancy intervals beyond 1-2 years have conferred an approximate 10% increased risk of pre eclampsia per year since the prior pregnancy, although the contributions of excess weight could not be excluded.
However, despite having a shorter interpregnancy interval, I am not stressed. The risks of adverse outcomes associated with short interpregnancy intervals are modest, based on low certainty evidence, and will likely be detected during routine prenatal care. Under the care of my OB, we are working together to reduce risks and taking it each trimester at a time!
Thank you so much for following me along on this journey to baby #2. More updates to come!
Dr. Shweta Desai
Want to catch up on my first pregnancy journey? Follow along in the pregnancy journey topic!