Threatened abortion: A risk factor for poor pregnancy outcome, a population-based screening study.
OBJECTIVE
The purpose of this study was to determine whether patients with first-trimester threatened abortion are at increased risk for poor pregnancy outcome.


METHODS
A large prospective multicenter database was studied. Subjects were divided into three groups: (1) no bleeding, (2) light bleeding, and (3) heavy bleeding. Univariate and multivariable logistic regression analyses were used.


RESULTS
The study comprised 16,506 patients: 14,160 patients without bleeding, 2094 patients with light bleeding, and 252 patients with heavy bleeding. Patients with vaginal bleeding, light or heavy, were more likely to experience a spontaneous loss before 24 weeks of gestation (odds ratio, 2.5 and 4.2, respectively) and cesarean delivery (odds ratio, 1.1 and 1.4, respectively). Light bleeding subjects were more likely to have preeclampsia (odds ratio, 1.5), preterm delivery (odds ratio, 1.3), and placental abruption (odds ratio, 1.6). Heavy vaginal bleeding subjects were more likely to have intrauterine growth restriction (odds ratio, 2.6), preterm delivery (odds ratio, 3.0), preterm premature rupture of membranes (odds ratio, 3.2), and placental abruption (odds ratio, 3.6).


CONCLUSIONS
First-trimester vaginal bleeding is an independent risk factor for adverse obstetric outcome that is directly proportional to the amount of bleeding.
Weiss
Joshua L
JL
Columbia Presbyterian Medical Center, New York, NY, USA.
Malone
Fergal D
FD
Vidaver
John
J
Ball
Robert H
RH
Nyberg
David A
DA
Comstock
Christine H
CH
Hankins
Gary D
GD
Berkowitz
Richard L
RL
Gross
Susan J
SJ
Dugoff
Lorraine
L
Timor-Tritsch
Ilan E
IE
D'Alton
Mary E
ME
D000022:Abortion, Spontaneous / Q000453:epidemiology / Q000209:etiology; D000033:Abortion, Threatened / Q000150:complications / Q000503:physiopathology*; D000037:Abruptio Placentae / Q000209:etiology; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D007752:Obstetric Labor, Premature / Q000209:etiology; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000150:complications; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D012307:Risk Factors; D012720:Severity of Illness Index; D014592:Uterine Hemorrhage / Q000150:complications / Q000503:physiopathology