Perinatal outcome of pregnancies complicated by vaginal bleeding.
OBJECTIVE
To examine the effect of first and/or second trimester vaginal bleeding on pregnancy outcome.


METHODS
A prospective one-year birth cohort.


METHODS
Two northernmost administrative districts of Finland.


METHODS
8718 singleton pregnancies, of whom 807 (9.3%) reported bleeding during the first (601) and/or second trimester (206); light bleeding in 595 cases and heavy bleeding in 212. The remaining 7911 women served as a reference group.


METHODS
Low birth weight rate (LBW), preterm birth rate, congenital malformations and perinatal mortality rate.


RESULTS
Bleeding was most frequent in women of more advanced age (> or = 35 years old), with previous miscarriages, with infertility problems or using an IUCD prior to the pregnancy. Parity, smoking and social status were not associated with bleeding. Caesarean section rate and placental complications during the third trimester and at delivery were more common among the bleeders than in the reference group. The LBW rate was three-fold among the bleeders and the preterm birth rate two-fold. The risk (OR) of a LBW infant among second trimester bleeders was 4.1 (95% CI 2.6-6.4), that of preterm birth 2.9 (95% CI 1.9-4.6), and that of congenital malformations 2.9 (95% CI 1.7-4.7). No association existed between bleeding and perinatal mortality.


CONCLUSIONS
Bleeding during the second trimester indicates a poor pregnancy outcome and an increased risk of LBW, and preterm birth and/or congenital malformation.
Sipilä
P
P
Department of Obstetrics and Gynaecology, University of Oulu, Finland.
Hartikainen-Sorri
A L
AL
Oja
H
H
Von Wendt
L
L
D000328:Adult; D002585:Cesarean Section; D015331:Cohort Studies; D005260:Female; D005387:Finland; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000209:etiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D014592:Uterine Hemorrhage / Q000150:complications*