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Cited by 228Pregnancy and preeclampsia studiesPreterm Birth and ChorioamnionitisMaternal and Perinatal Health Interventions

Maternal and perinatal outcome in women with threatened miscarriage in the first trimester: a systematic review

Saraswat, L, Bhattacharya, S, Maheshwari, A, Bhattacharya, S·2010·BJOG: An International Journal of Obstetrics & Gynaecology
DOI 10.1111/j.1471-0528.2009.02427.x
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Abstract

BACKGROUND: Threatened miscarriage is a common complication in the first trimester of pregnancy and is often associated with anxiety regarding pregnancy outcome. OBJECTIVE: We undertook a systematic review to explore the effects of threatened miscarriage in the first trimester on maternal and perinatal outcomes. SEARCH STRATEGY: An electronic literature search using MEDLINE and EMBASE, and bibliographies of retrieved primary articles. No language restrictions were applied. SELECTION CRITERIA: All studies analysing outcomes of first-trimester bleeding where viability was confirmed on ultrasound or the pregnancy continued beyond viability. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies and extracted data on study characteristics, quality and accuracy. Meta-analysis was performed using Review Manager software. MAIN OUTCOME MEASURES: The outcome was broadly categorised into maternal and perinatal outcomes. The chief maternal outcomes included pre-eclampsia/eclampsia or pregnancy-induced hypertension, antepartum haemorrhage, preterm prelabour rupture of membranes (PPROM) and mode of delivery. The perinatal outcomes evaluated were preterm delivery, low birthweight, intrauterine growth restriction, perinatal mortality, indicators of perinatal morbidity (Apgar scores and neonatal unit admission) and presence of congenital anomalies. MAIN RESULTS: Fourteen studies met the inclusion criteria. Women with threatened miscarriage had a significantly higher incidence of antepartum haemorrhage due to placenta praevia [odds ratio (OR) 1.62, 95% CI 1.19, 2.22] or antepartum haemorrhage of unknown origin (OR 2.47, 95% CI 1.52, 4.02) when compared with those without first-trimester bleeding. They were more likely to experience PPROM (OR 1.78, 95% CI 1.28, 2.48), preterm delivery (OR 2.05, 95% CI 1.76, 2.4) and to have babies with intrauterine growth restriction (OR 1.54, 95% CI 1.18, 2.00). First-trimester bleeding was associated with significantly higher rates of perinatal mortality (OR 2.15, 95% CI 1.41, 3.27) and low-birthweight babies (OR 1.83, 95% CI 1.48, 2.28). AUTHORS' CONCLUSIONS: Threatened miscarriage in the first trimester is associated with increased incidence of adverse maternal and perinatal outcome.

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  • Bacterial, viral and protozoa infections have all been linked to miscarriage.

    “Bacterial (bacterial vaginosis, brucellosis, chlamydia trachomatis, and syphilis), viral (herpes virus: HSV-1 and HSV-2, human CMV, human papillomavirus, parvovirus, adeno-associated viruses, parvovirus B19, bocavirus, HIV, polyomavirus, Dengue fever, hepatitis B, hepatitis C, rubella, coronaviruses [SARS, MERS and H1N1]) and protozoa (malaria and toxoplasmosis) infections have all been linked to”

    From Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss (2021) · cites this paper as [85]

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Authors
Saraswat, L., Bhattacharya, S., Maheshwari, A., & Bhattacharya, S.
Affiliations
  • Aberdeen Maternity Hospital (GB)
  • University of Aberdeen (GB)
Corresponding author
Saraswat, L
ORCID
Venue
BJOG: An International Journal of Obstetrics & Gynaecology
Publisher
Wiley
Published
2010-01-12
Volume
117
Issue
3
Pages
245-257
ISSN
  • 0306-5456 (ISSN-L)
  • 1470-0328
  • 1471-0528
DOI
10.1111/j.1471-0528.2009.02427.x
OpenAlex
W1494944113
Cited by
228
References
23
Citations by year
2026: 6 · 2025: 15 · 2024: 27 · 2023: 19 · 2022: 22 · 2021: 21 · 2020: 11 · 2019: 15 · 2018: 12 · 2017: 17 · 2016: 9 · 2015: 10 · 2014: 11 · 2013: 6 · 2012: 9
FWCI
1.46
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
threatened abortion, first-trimester bleeding, maternal outcomes, perinatal outcomes, antepartum hemorrhage, placenta previa, preterm prelabour rupture of membranes, preterm birth, fetal growth restriction, perinatal mortality, low birth weight, congenital malformations, mode of delivery, preeclampsia, gestational hypertension
MeSH terms
Abortion, Threatened, Female, Premature Rupture of Fetal Membranes, Humans, Infant, Newborn, Pre-Eclampsia, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, First, Prognosis, Uterine Hemorrhage, Hypertension, Pregnancy-Induced, Perinatal Mortality

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