Does miscarriage in an initial pregnancy lead to adverse obstetric and perinatal outcomes in the next continuing pregnancy?
Does miscarriage in an initial pregnancy lead to adverse obstetric and perinatal outcomes in the next continuing pregnancy?
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DOI：
10.1111/j.1471-0528.2008.01943.x
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发表时间：
2008-12-01
影响因子：
5.8
通讯作者：
Bhattacharya, S.
中科院分区：
文献类型：
--
作者：
Bhattacharya, S.;Townend, J.;Bhattacharya, S.
探讨首次流产后妇女的妊娠结局。回顾性队列研究。阿伯丁妇产医院，阿伯丁，苏格兰。所有居住在苏格兰格兰扁地区的妇女，在1986年至2000年期间在阿伯丁妇产和新生儿数据库中记录妊娠。(A)产妇结局：先兆子痫、产前出血、先兆流产、胎位不正、引产、器械分娩、剖腹产、产后出血和人工剥离胎盘。(B)围产期结局：早产、低出生体重、死产、新生儿死亡、5分钟Apgar评分。回顾性队列研究比较了首次妊娠流产的妇女与（a）先前成功妊娠的妇女和（B）再次妊娠妇女。我们从1986年至2000年的Aberdeen孕产妇和新生儿数据库中提取了所有妇女的围产期结局数据。我们确定了1561名首次流产的妇女（1404名在孕早期，157名在孕中期），10549名有过活产史的妇女（A组）和21118名孕妇（B组）。流产组面临更高的先兆子痫风险（调整OR 3.3，99% CI 2.6-4.6），先兆流产（调整OR 1.7，99% CI 1.5-2.0），引产（调整OR 2.2，99% CI 1.9-2.5），器械给药（adj OR 5.9，99% CI 5.0-6.9）、早产（adj OR 2.1，99% CI 1.6-2.8）和低出生体重（adj OR 1.6，99% CI 1.3-2.1）。他们更有可能以流产相威胁（调整OR 1.5，99% CI 1.4-1.7），引产（调整OR 1.3，99% CI 1.2-1.5），产后出血（调整OR 1.4，99% CI 1.2-1.6）和早产（adj OR 1.5，99% CI 1.2-1.8）。初次流产与产科并发症的风险较高相关。
To explore pregnancy outcomes in women following an initial miscarriage.Retrospective Cohort Study.Aberdeen Maternity Hospital, Aberdeen, Scotland.All women living in the Grampian region of Scotland with a pregnancy recorded in the Aberdeen Maternity and Neonatal Databank between 1986 and 2000.(A) Maternal outcomes: Pre-eclampsia, antepartum haemorrhage, threatened miscarriage, malpresenation, induced labour, instrumental delivery, Caesarean delivery, postpartum haemorrhage and manual removal of placenta. (B) Perinatal outcomes: preterm delivery, low birth weight, stillbirth, neonatal death, Apgar score at 5 minutes.Retrospective cohort study comparing women with a first pregnancy miscarriage with (a) women with one previous successful pregnancy and (b) primigravid women. Data were extracted on perinatal outcomes in all women from the Aberdeen Maternity and Neonatal Databank between 1986 and 2000.We identified 1561 women who had a first miscarriage (1404 in the first trimester and 157 in the second trimester), 10 549 who had had a previous live birth (group A) and 21 118 primigravidae (group B). The miscarriage group faced a higher risk of pre-eclampsia (adj OR 3.3, 99% CI 2.6-4.6), threatened miscarriage (adj OR 1.7, 99% CI 1.5-2.0), induced labour (adj OR 2.2, 99% CI 1.9-2.5), instrumental delivery (adj OR 5.9, 99% CI 5.0-6.9), preterm delivery (adj OR 2.1, 99% CI 1.6-2.8) and low birthweight (adj OR 1.6, 99% CI 1.3-2.1) than group A. They were more likely to have threatened miscarriage (adj OR 1.5, 99% CI 1.4-1.7), induced labour (adj OR 1.3, 99% CI 1.2-1.5), postpartum haemorrhage (adj OR 1.4, 99% CI 1.2-1.6) and preterm delivery (adj OR 1.5, 99% CI 1.2-1.8) than group B.An initial miscarriage is associated with a higher risk of obstetric complications.