Parental Perceptions of Counseling Regarding Interpregnancy Interval after Stillbirth or Neonatal Death

Abstract

Objective 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.

Study Design 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.

Results 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 (p < 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.

Conclusion 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.

Key Points

• 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.

Keywords

stillbirth - neonatal death - interpregnancy interval - patient centered

Note

This study was approved by the University of Utah Institutional Review Board (identifier: 00113313).

Publication History

Received: 19 October 2022

Accepted: 06 March 2023

Accepted Manuscript online:
14 March 2023

Article published online:
18 April 2023

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