Objective To determine the optimum interpregnancy interval after miscarriage in a first recorded pregnancy. Design Population based retrospective cohort study. Setting Scottish hospitals between 1981 and 2000. Participants 30 937 women who had a miscarriage in their first recorded pregnancy and subsequently became pregnant. Main outcome measures The primary end point was miscarriage, live birth, termination, stillbirth, or ectopic pregnancy in the second pregnancy. Secondary outcomes were rates of caesarean section and preterm delivery, low birthweight infants, pre-eclampsia, placenta praevia, placental abruption, and induced labour in the second pregnancy. Results Compared with women with an interpregnancy interval of 6-12 months, those who conceived again within six months were less likely to have another miscarriage (adjusted odds ratio 0.66, 95% confidence interval 0.57 to 0.77), termination (0.43, 0.33 to 0.57), or ectopic pregnancy (0.48, 0.34 to 0.69). Women with an interpregnancy interval of more than 24 months were more likely to have an ectopic second pregnancy (1.97, 1.42 to 2.72) or termination (2.40, 1.91 to 3.01). Compared with women with an interpregnancy interval of 6-12 months, women who conceived again within six months and went on to have a live birth in the second pregnancy were less likely to have a caesarean section (0.90, 0.83 to 0.98), preterm delivery (0.89, 0.81 to 0.98), or infant of low birth weight (0.84, 0.71 to 0.89) but were more likely to have an induced labour (1.08, 1.02 to 1.23).Conclusions Women who conceive within six months of an initial miscarriage have the best reproductive outcomes and lowest complication rates in a subsequent pregnancy.

II-2.

While women prefer comprehensive information, the bulk of the value is placed on knowing whether the fetus has Down syndrome. Given the longer wait times for comprehensive information, simple information is preferred as long as results are received 6 days sooner than would be the case for comprehensive information. These results have implications for the resources dedicated to providing a rapid prenatal diagnostic service.

Symptoms of bronchial hyperreactivity and asthma in relation to environmental factors. Arch Dis Child 1988;63:473-8. 18 Lunn JE, Knowelden J, Roe JW. Pattems of respiratory illness in Sheffield junior schoolchildren-a follow up study. BrJ Prev Soc Med 1970;24:223-8. 19 Ware JH, Ferris BG Jr, Dockerv DW, Spengler JD, Stram DO, Speizer FE.Effects of ambient sulfur oxides and suspended particles on respiratory health of pre-adolescent children. Am Rev Respir Dis 1986;133:834-42. 20 Braun-Fahrlander C, Ackermann-Liebrich U, Schwartz

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