Perinatal outcomes in singleton and twin pregnancies following first-trimester bleeding.
OBJECTIVE
To investigate associations between first-trimester bleeding and perinatal outcomes.


METHODS
Registry-based survey of the period 2002 through 2010. Pregnancies with versus without first-trimester bleeding were compared using Student's t- and χ(2)-test. Multivariable logistic regression was used to control for potential confounders.


RESULTS
9924 singleton and 275 twin pregnancies with first-trimester bleeding, and 160 099 singleton and 2710 twin pregnancies without bleeding were included. Bleeding increased the risk of preterm birth in singletons (odds ratio 1.48; 95% confidence interval 1.38-1.60). Risks were also increased for preterm premature rupture of membranes, abruption, previa, stillbirth and congenital anomalies, with a reduced risk of preeclampsia. The differences remained significant after adjustment for confounders. In twin pregnancies, bleeding was not significantly associated with prematurity (odds ratio 1.04; 95% confidence interval 0.81-1.34), nor with other outcomes.


CONCLUSIONS
In singletons, but not in twins, the risk of perinatal complications is significantly increased after first-trimester bleeding.
Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
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M
Lucovnik
Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
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N
Tul
Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
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I
Verdenik
Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot, affiliated with the Hadassah-Hebrew University school of Medicine, Jerusalem, Israel.
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I
Blickstein
D000037:Abruptio Placentae / Q000209:etiology; D000328:Adult; D000013:Congenital Abnormalities / Q000209:etiology; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D010923:Placenta Previa / Q000209:etiology; D011225:Pre-Eclampsia / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications; D011261:Pregnancy Trimester, First; D059285:Pregnancy, Twin; D047928:Premature Birth / Q000209:etiology; D014592:Uterine Hemorrhage / Q000150:complications*