Is there an ideal interpregnancy interval after a live birth, miscarriage or other adverse pregnancy outcomes?

Advice given to women regarding optimum interpregnancy interval (IPI) following spontaneous miscarriage remains controversial. There is robust evidence from many studies including a meta-analysis that after full term or pre-term delivery, IPIs of <18 months and >5 years are associated with increased risk of poor perinatal and maternal outcome. However, there is paucity of good studies to infer the effect of IPI after a spontaneous miscarriage, which is a relatively common event. The results have been variable and inconsistent but a recent good quality study (DaVanzo et al. 2007 ) showed similar pregnancy outcome with IPIs of <6, 6-14, 15-26 and 27-50 months following spontaneous miscarriage. Hence, it seems reasonable to attempt conception soon after an uncomplicated miscarriage in otherwise healthy women depending on their desire. More good quality, preferably prospective studies regarding effect IPI after miscarriage are required for better evidence-based advice.