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    Pregnancy Spacing Affects Outcome

    Very Short and Long Intervals Increase Risk

    Breastfeeding and Birth Control

    Based on this analysis and his own studies, Conde-Agudelo says he's now convinced that birth spacing is the most effective intervention available for preventing deaths among newborns.

    In an editorial accompanying the study, Royce writes that interventions to increase the time between pregnancies, such as encouraging breastfeeding and improving access to birth control, could reduce infant deaths.

    Breastfeeding is a natural, although not infallible, form of birth control. So women who follow recommendations to breastfeed exclusively for at least the first six months of her baby's life would be both optimizing the nutritionnutrition she provides that baby and lowering her risk of having an adverse pregnancypregnancy outcome the next time she gives birth.

    New moms may also want to continue taking their vitamins after giving birth to reduce her risk. It has been suggested that depletion of maternal stores of folate during and after pregnancy may be responsible for poor outcomes.

    This theory was bolstered by one study, which found that neural tube defects (such as spina bifida) were more likely to occur among children conceived within six months of a previous live birth, compared with those conceived after one to two years.

    It is less clear, Royce says, why longer intervals between pregnancies would be associated with increased risk.

    "While longer intervals are likely to be beyond personal control, pregnancies occurring after an interval longer than 60 months may require more careful monitoring to avoid [unwanted] outcomes," she writes.

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