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妊娠前3个月阴道出血与妊娠后期并发症

First-Trimester Vaginal Bleeding and Complications Later in Pregnancy
Lykke JA, Dideriksen KL, Lidegaard Ø   |    2010/8/19 14:02:24   | 
Obstet Gynecol  |   2010   |          View at Publisher
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上一篇： 足月妊娠引产与期待疗法之比较
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Objective:
To evaluate the association of first-trimester bleeding without miscarriage and complications later in the first pregnancy as well as in the next pregnancy.

Methods:
In a retrospective, registry-based cohort study, we identified women delivering in Denmark from 1978 to 2007 with a first singleton pregnancy (n=782,287) and first and second singleton pregnancies (n=536,419). First-trimester bleeding is defined as vaginal bleeding before 12 full weeks of gestation. We employed multivariate logistic regression with adjustment for maternal age and calendar year.

Results:
First-trimester bleeding increased the risk of delivery in weeks 32–36 from 3.6% to 6.1% (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.57–1.77) and in weeks 28–31 from 0.3% to 0.9% (OR 2.98; 95% CI 2.50–3.54) and increased the risk of placental abruption from 1.0% to 1.4% (OR 1.48; 95% CI 1.30–1.68).

First-trimester bleeding in the first pregnancy increased the risk of recurrence in the second pregnancy from 2.2% to 8.2% (OR 4.05; 95% CI 3.78–4.34), preterm delivery from 2.7% to 4.8% (OR 1.83; 95% CI 1.67–2.00), and placental abruption from 0.9% to 1.0% (OR 1.29; 95% CI 1.07–1.56) in the second pregnancy.

Conclusion:
Women with first-trimester bleeding in the first pregnancy have an increased risk of complications later in the first pregnancy and of recurrence of first-trimester bleeding and other complications in the second pregnancy.
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