title: The association of first trimester bleeding with preterm delivery.
abstract: BACKGROUND
  Preterm birth (PTB) is a predictor of perinatal morbidity and mortality, and prematurity continues to burden public healthcare with growing expenses. First trimester bleeding (FTB) has a well-known association with PTB; however, the relationship with severity of PTB is less obvious.
  
  
  OBJECTIVE
  The primary aim of the study was to analyze the influence of FTB on the risk and severity of PTB, as well as to assess the connection of FTB and other pregnancy complications.
  
  
  METHODS
  It was an observational case control study. The material consisted of medical records of patients who delivered between 2010 and 2013. Two groups were formed - 497 women with FTB and 500 women without bleeding.
  
  
  RESULTS
  Women with FTB were more likely to deliver preterm in general (OR=2.11; 95% CI 1.43-3.10). The risk of extremely PTB (<28 weeks) was almost four-fold (OR=3.76; 95% CI 0.97-17.06) and very PTB (28-31 weeks) more than three-fold (OR=3.41; 95% CI 0.86-15.69). FTB increased the risk of placenta previa (OR=4.81; 95% CI 1.29-20.53; P=0.007).
  
  
  CONCLUSIONS
  FTB is a risk factor of PTB and is associated with greater risk of PTB-related pregnancy complications. Management of FTB pregnancies should include thorough screening for both preterm delivery and placental pathologies.
authors.forename: Iwona
authors.initials: I
authors.lastname: Szymusik
authors.forename: Pawel
authors.initials: P
authors.lastname: Bartnik
authors.forename: Klaudia
authors.initials: K
authors.lastname: Wypych
authors.forename: Halszka
authors.initials: H
authors.lastname: Kolaczkowska
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kosinska-Kaczynska
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Wielgos
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006470:Hemorrhage / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D010923:Placenta Previa / Q000209:etiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology*; D011261:Pregnancy Trimester, First; D047928:Premature Birth / Q000209:etiology*; D012307:Risk Factors; D055815:Young Adult