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Maternal and perinatal consequences of antepartum haemorrhage of unknown origin.
BJOG. 2014 Jan; 121(1):44-50; discussion 50-2.BJOG

Abstract

OBJECTIVE

To explore the risk of adverse maternal and perinatal outcomes in women with antepartum bleeding of unknown origin (ABUO).

DESIGN

Cohort study based on data extracted from the Aberdeen Maternity and Neonatal Databank. Exposure was antepartum haemorrhage occurring after the first trimester not attributable to placenta praevia or placental abruption.

SETTING

Aberdeen Maternity Hospital, Aberdeen, Scotland, UK.

POPULATION

All primigravidae delivering between 1976 and 2010.

METHODS

Data were analysed using univariate and multivariate statistical methods.

MAIN OUTCOME MEASURES

Pre-eclampsia, induced labour, mode of delivery, preterm delivery, postpartum haemorrhage, admission to neonatal unit, perinatal death.

RESULTS

Between 1976 and 2010, there were 7517 women with ABUO and 68,423 women without ABUO in the cohort. Women with ABUO were more likely to be non-smokers, belong to a lower social class, and have a higher body mass index. ABUO was a significant risk factor for induced labour (adjusted odds ratio, aOR, 1.23; 95% CI 1.16-1.31), preterm delivery at <37 weeks of gestation (aOR 2.30; 95% CI 2.11-2.50), and postpartum haemorrhage (aOR 1.15; 95% CI 1.06-1.25). There was no significant association detected with pre-eclampsia (aOR 0.93; 95% CI 0.83-1.05). Whereas there was an increased risk of low birthweight (aOR 0.90; 95% CI 0.79-1.03) and stillbirth (aOR 0.92; 95% CI 0.66-1.30) with ABUO on univariate analysis, once adjusted for confounding factors this risk was non-significant.

CONCLUSION

Pregnancies complicated by ABUO are at a greater risk of preterm delivery and induced labour. There was no increase seen in perinatal mortality after adjusting for preterm birth.

Authors+Show Affiliations

Epidemiology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24125550

Citation

Bhandari, S, et al. "Maternal and Perinatal Consequences of Antepartum Haemorrhage of Unknown Origin." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 121, no. 1, 2014, pp. 44-50; discussion 50-2.
Bhandari S, Raja EA, Shetty A, et al. Maternal and perinatal consequences of antepartum haemorrhage of unknown origin. BJOG. 2014;121(1):44-50; discussion 50-2.
Bhandari, S., Raja, E. A., Shetty, A., & Bhattacharya, S. (2014). Maternal and perinatal consequences of antepartum haemorrhage of unknown origin. BJOG : an International Journal of Obstetrics and Gynaecology, 121(1), 44-50; discussion 50-2. https://doi.org/10.1111/1471-0528.12464
Bhandari S, et al. Maternal and Perinatal Consequences of Antepartum Haemorrhage of Unknown Origin. BJOG. 2014;121(1):44-50; discussion 50-2. PubMed PMID: 24125550.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal and perinatal consequences of antepartum haemorrhage of unknown origin. AU - Bhandari,S, AU - Raja,E A, AU - Shetty,A, AU - Bhattacharya,S, Y1 - 2013/10/15/ PY - 2013/07/22/accepted PY - 2013/10/16/entrez PY - 2013/10/16/pubmed PY - 2014/2/12/medline KW - Antepartum haemorrhage of unknown origin KW - maternal outcomes KW - perinatal outcomes KW - preterm delivery SP - 44-50; discussion 50-2 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 121 IS - 1 N2 - OBJECTIVE: To explore the risk of adverse maternal and perinatal outcomes in women with antepartum bleeding of unknown origin (ABUO). DESIGN: Cohort study based on data extracted from the Aberdeen Maternity and Neonatal Databank. Exposure was antepartum haemorrhage occurring after the first trimester not attributable to placenta praevia or placental abruption. SETTING: Aberdeen Maternity Hospital, Aberdeen, Scotland, UK. POPULATION: All primigravidae delivering between 1976 and 2010. METHODS: Data were analysed using univariate and multivariate statistical methods. MAIN OUTCOME MEASURES: Pre-eclampsia, induced labour, mode of delivery, preterm delivery, postpartum haemorrhage, admission to neonatal unit, perinatal death. RESULTS: Between 1976 and 2010, there were 7517 women with ABUO and 68,423 women without ABUO in the cohort. Women with ABUO were more likely to be non-smokers, belong to a lower social class, and have a higher body mass index. ABUO was a significant risk factor for induced labour (adjusted odds ratio, aOR, 1.23; 95% CI 1.16-1.31), preterm delivery at <37 weeks of gestation (aOR 2.30; 95% CI 2.11-2.50), and postpartum haemorrhage (aOR 1.15; 95% CI 1.06-1.25). There was no significant association detected with pre-eclampsia (aOR 0.93; 95% CI 0.83-1.05). Whereas there was an increased risk of low birthweight (aOR 0.90; 95% CI 0.79-1.03) and stillbirth (aOR 0.92; 95% CI 0.66-1.30) with ABUO on univariate analysis, once adjusted for confounding factors this risk was non-significant. CONCLUSION: Pregnancies complicated by ABUO are at a greater risk of preterm delivery and induced labour. There was no increase seen in perinatal mortality after adjusting for preterm birth. SN - 1471-0528 UR - https://www.unboundmedicine.com/medline/citation/24125550/Maternal_and_perinatal_consequences_of_antepartum_haemorrhage_of_unknown_origin_ L2 - https://doi.org/10.1111/1471-0528.12464 DB - PRIME DP - Unbound Medicine ER -