Renas Jamal Rahman a, and Chro Najmaddin Fattah b

a  Sulaimani Maternity Teaching Hospital, Ministry of Health, Kurdistan Region, Iraq.

b Department of Gynecology and Obstetrics, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

Submitted: 5/6/2021; Accepted: 24/11/2021; Published: 21/3/2022

DOI Link: https://doi.org/10.17656/jsmc.10344 



Interpregnancy interval is a modifiable risk factor for adverse outcomes in infants and their mothers. The World Health Organization proposed that women wait a minimum of twenty-four months following a live birth and six months following a miscarriage before conceiving again.


The aim is to assess the outcome of pregnancy and complications correlated with an interpregnancy interval following a prior pregnancy loss.

Patients and Methods

This is a prospective comparative study that includes 100 patients in a maternity teaching hospital in Sulaymaniyah - Iraq, between April 2020 to March 2021, divided into two groups of 50 patients each, as groups A and B. One group has an interpregnancy interval <3 months and the other group has interpregnancy interval ≥ 3 months.

This study included women whose final reproductive outcomes were a pregnancy loss and afterwards became pregnant.

The study outcome included the outcome of the pregnancy, whether delivered by caesarian section or vaginal delivery, the outcome of the baby including birth weight and APGAR score in 1 minute and 10 minutes, and whether admitted to the Neonatal Care Unit or not. The outcome also included the pregnancy complications such as pregnancy loss, type of the pregnancy loss, and complications of the pregnancy (pre-eclampsia, gestational diabetes, and preterm birth <37weeks).


The pregnancy outcomes turned out as 76 cases of live births, and 24 cases of miscarriage. From live births, 58 cases were delivered vaginally, and 18 cases were delivered by caesarean section. 


This study showed that conception within 12 weeks of prior miscarriage, was not related to an increased liability of poor pregnancy outcomes.


Pregnancy interval, Pregnancy loss.


1. Schummer's L, Hutcheon JA, Hernandez-Diaz S, Williams PL, Hacker MR, VanderWeele TJ, et al. Association of the short interpregnancy interval with pregnancy outcomes according to maternal age. JAMA internal medicine. 2018; 178(12):1661-70.

2. Regan AK, Gissler M, Magnus MC, Håberg SE, Ball S, Malacova E, et al. Association between interpregnancy interval and adverse birth outcomes in women with a previous stillbirth: an international cohort study. The Lancet. 2019; 393(10180):1527-35.

3. Wong LF, Schliep KC, Silver RM, Mumford SL, Perkins NJ, Ye A, et al. The effect of a very short interpregnancy interval and pregnancy outcomes following a previous pregnancy loss. American journal of obstetrics and gynaecology. 2015; 212(3):375. 

4. Swaminathan A, Fell DB, Regan A, Walker M, Corsi DJ. Association between interpregnancy interval and subsequent stillbirth in 58 low-income and middle-income countries: a retrospective analysis using demographic and health surveys. The Lancet Global Health. 2020; 8(1):e113-e22.

5. DaVanzo J, Hale L, Rahman M. How long after a miscarriage should women wait before becoming pregnant again? Multivariate analysis of cohort data from Matlab, Bangladesh. BMJ Open. 2012; 2(4):e001591.

6. DaVanzo J, Hale L, Razzaque A, Rahman M. Effects of interpregnancy interval and outcome of the preceding pregnancy on pregnancy outcomes in Matlab, Bangladesh. BJOG: An International Journal of Obstetrics & Gynaecology. 2007; 114(9):1079-87.

7. Conde-Agudelo A, Belizán JM, Norton MH, Rosas-Bermúdez A. Effect of the interpregnancy interval on perinatal outcomes in Latin America. Obstetrics & Gynecology. 2005; 106(2):359-66.

8. Zhu B-P, Rolfs RT, Nangle BE, Horan JM. Effect of the interval between pregnancies on perinatal outcomes. New England journal of medicine. 1999; 340(8):589-94.

9. Habimana-Kabano I, Broekhuis A, Hooimeijer P. The effects of Interpregnancy intervals and previous pregnancy outcome on fetal loss in Rwanda (1996–2010). International Journal of reproductive medicine. 2015; 2015: 413917.

10. Wilcox AJ, Weinberg CR, O'Connor JF, Baird DD, Schlatterer JP, Canfield RE, et al. Incidence of early pregnancy loss. New England Journal of Medicine. 1988; 319(4):189-94.

11. Rai R, Regan L. Recurrent miscarriage. The lancet. 2006; 368(9535):601-11.

12. Luesley DM, Kilby M, editors. Obstetrics & Gynaecology: An evidence-based text for MRCOG. CRC Press; 2016 Mar 30.

13. Regan L, Backos M, Rai R. Recurrent Miscarriage, investigation and treatment of couples. Royal College of Obstetricians and Gynaecologists. 2011.

14. Gemmill A, Lindberg LD. Short interpregnancy intervals in the United States. Obstetrics and gynaecology. 2013; 122(1):64.

15. Lean SC, Derricott H, Jones RL, Heazell AE. Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis. PloS one. 2017; 12(10):e0186287.

16. Edmonds K, editor. Dewhurst's textbook of obstetrics and gynaecology. John Wiley & Sons; 2011 Nov 29.

17. Glover AV, Manuck TA. Screening for spontaneous preterm birth and resultant therapies to reduce neonatal morbidity and mortality: A review. Seminars in Fetal and Neonatal Medicine 2018 Apr 1 (Vol. 23, No. 2, pp. 126-132). WB Saunders.

18. Klerman LV, Cliver SP, Goldenberg RL. The impact of short interpregnancy intervals on pregnancy outcomes in a low-income population. American Journal of Public Health. 1998; 88(8):1182-5.

19. Bentolila Y, Ratzon R, Shoham-Vardi I, Serjienko R, Mazor M, Bashiri A. Effect of interpregnancy interval on pregnancy outcomes after recurrent pregnancy loss. The Journal of Maternal-Fetal & Neonatal Medicine. 2013; 26(14):1459-64.

20. Love ER, Bhattacharya S, Smith NC, Bhattacharya S. Effect of interpregnancy interval on pregnancy outcomes after miscarriage: retrospective analysis of hospital episode statistics in Scotland. BMJ. 2010; 341:c3967.

21. El Behery MM, Siam S, Seksaka MA, Ibrahim ZM. Reproductive performance in the next pregnancy for nulliparous women with a history of first-trimester spontaneous abortion. Archives of gynaecology and obstetrics. 2013; 288(4):939-44.Health & place. 2003 Sep 1;9(3):207-18.

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