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
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There is variation in IPI recommendation after stillbirth/neonatal death.
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Cesarean birth is associated with longer IPI recommendation, but maternal age is not.
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Median IPI after stillbirth or neonatal death was short: 6 (IQR: 4–10) months.
Keywords
stillbirth - neonatal death - interpregnancy interval - patient centered
