News | How Do Pregnancy Complications Affect Women's Likelihood of Having Another Child? Study Finds an Important Association
On November 25, 2024, a study by researchers at Karolinska Institutet published in JAMA found that women who experienced severe complications during their first pregnancy or delivery were often less likely to have another child. The findings have prompted greater attention to monitoring in prenatal and postpartum care, particularly as Sweden's birth rate has continued to decline in recent years.
Study Finds a Link Between Severe Complications and Subsequent Childbearing
Using data from more than 1 million women who had their first delivery in Sweden between 1999 and 2021, the study analyzed the relationship between severe maternal morbidity during the first pregnancy and the likelihood of a subsequent birth. Women who experienced severe complications were significantly less likely to have another child.
Lead author Eleni Tsamantioti, a doctoral student at the Department of Medicine, Solna, Karolinska Institutet, said clinical follow-up is essential for these women and that they need personalized pregnancy counseling to address possible physical and psychological effects.
Which Complications Had the Greatest Effect?
Overall, 3.5% of first-time mothers in the study experienced severe complications, and they were 12% less likely to have another child. The largest effects were associated with:
Cardiac complications, uterine rupture, or severe mental health conditions: a 50% lower likelihood of another birth.
Respiratory treatment or cerebrovascular events, such as stroke or intracranial hemorrhage: a 40% lower likelihood.
Acute kidney failure, severe preeclampsia, and blood-clotting disorders also significantly reduced the likelihood of a second pregnancy.
By comparing the women with their sisters, the team also accounted for the effects of familial genetic factors.
Psychological and Social Factors May Be Key
Last author Neda Razaz, associate professor at Karolinska Institutet, said these health events may have long-term effects on women's physical and mental health. Multiple factors may explain the lower likelihood of another birth, including reduced desire for more children, psychological trauma, infertility caused by medication used to treat psychiatric illness, or inadequate health guidance.
Tsamantioti added: “It is therefore especially important for prenatal care professionals to provide appropriate support and monitoring to women who have experienced serious health problems.”
Significance and Future Outlook
The team emphasized that the findings provide new evidence for maternal health and identify clear opportunities to improve prenatal care. Personalized health management, pregnancy counseling, and psychological support may help improve the likelihood of subsequent births among these women.
The study was funded by the Swedish Heart-Lung Foundation, Region Stockholm, the ALF project, and the Swedish Research Council.
News | How Do Pregnancy Complications Affect Women's Likelihood of Having Another Child? Study Finds an Important Association
News | How Do Pregnancy Complications Affect Women's Likelihood of Having Another Child? Study Finds an Important Association
On November 25, 2024, a study by researchers at Karolinska Institutet published in JAMA found that women who experienced severe complications during their first pregnancy or delivery were often less likely to have another child. The findings have prompted greater attention to monitoring in prenatal and postpartum care, particularly as Sweden's birth rate has continued to decline in recent years.
Study Finds a Link Between Severe Complications and Subsequent Childbearing
Using data from more than 1 million women who had their first delivery in Sweden between 1999 and 2021, the study analyzed the relationship between severe maternal morbidity during the first pregnancy and the likelihood of a subsequent birth. Women who experienced severe complications were significantly less likely to have another child.
Lead author Eleni Tsamantioti, a doctoral student at the Department of Medicine, Solna, Karolinska Institutet, said clinical follow-up is essential for these women and that they need personalized pregnancy counseling to address possible physical and psychological effects.
Which Complications Had the Greatest Effect?
Overall, 3.5% of first-time mothers in the study experienced severe complications, and they were 12% less likely to have another child. The largest effects were associated with:
Cardiac complications, uterine rupture, or severe mental health conditions: a 50% lower likelihood of another birth.
Respiratory treatment or cerebrovascular events, such as stroke or intracranial hemorrhage: a 40% lower likelihood.
Acute kidney failure, severe preeclampsia, and blood-clotting disorders also significantly reduced the likelihood of a second pregnancy.
By comparing the women with their sisters, the team also accounted for the effects of familial genetic factors.
Psychological and Social Factors May Be Key
Last author Neda Razaz, associate professor at Karolinska Institutet, said these health events may have long-term effects on women's physical and mental health. Multiple factors may explain the lower likelihood of another birth, including reduced desire for more children, psychological trauma, infertility caused by medication used to treat psychiatric illness, or inadequate health guidance.
Tsamantioti added: “It is therefore especially important for prenatal care professionals to provide appropriate support and monitoring to women who have experienced serious health problems.”
Significance and Future Outlook
The team emphasized that the findings provide new evidence for maternal health and identify clear opportunities to improve prenatal care. Personalized health management, pregnancy counseling, and psychological support may help improve the likelihood of subsequent births among these women.
The study was funded by the Swedish Heart-Lung Foundation, Region Stockholm, the ALF project, and the Swedish Research Council.
Source:
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