Karolinska Institutet, A new study published in JAMA by researchers at Karolinska Institutet reveals that women who experience severe complications during their first pregnancy or delivery are significantly less likely to have subsequent children. This finding comes amid a concerning trend of declining birth rates in Sweden, prompting researchers to advocate for enhanced monitoring and support in antenatal care.
The study, led by doctoral student Eleni Tsamantioti, emphasizes the importance of tailored clinical monitoring and individualized guidance for women considering future pregnancies after experiencing serious health issues. “It is crucial that these women receive proper support and advice regarding their reproductive options,” Tsamantioti stated.
Analyzing data from over one million women in Sweden who gave birth for the first time between 1999 and 2021, the researchers explored the impact of severe maternal morbidity on the likelihood of having a second child. The results indicate that 3.5% of first-time mothers encountered serious complications, leading to a 12% reduction in the likelihood of having another baby.
The study identified that women suffering from specific complications, such as cardiac issues, ruptured uterus, or severe mental health challenges, were particularly affected. Those women were found to be 50% less likely to conceive again compared to their peers without such complications. Additionally, women requiring respiratory care or experiencing cerebrovascular incidents, such as strokes or intracranial hemorrhages, had a 40% lower chance of having a second child.
Other serious conditions, including acute kidney failure, severe preeclampsia, and blood clotting disorders, were also associated with reduced probabilities of subsequent pregnancies. To account for familial factors, the researchers compared the reproductive outcomes of women with their sisters.
“The reasons behind this trend are complex and may stem from various factors, including a diminished desire for more children, trauma from the experience, infertility related to psychiatric medications, or inadequate health counseling,” Tsamantioti explained. “Therefore, proper support and monitoring from antenatal care professionals are essential for women who have endured serious health complications during their pregnancies.”
The study was supported by funding from the Swedish Heart-Lung Foundation, Region Stockholm, the ALF scheme, and the Swedish Research Council.
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