Bhattacharya S, Townend J, Shetty A, Campbell D, Bhattacharya S
Dugald Baird Centre for Research on Women's Health, Aberdeen Maternity Hospital, Aberdeen, UK.
BJOG. 2008 Dec;115(13):1623-9. doi: 10.1111/j.1471-0528.2008.01943.x.
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.
探讨首次流产后女性的妊娠结局。
回顾性队列研究。
苏格兰阿伯丁的阿伯丁妇产医院。
1986年至2000年间在阿伯丁妇产及新生儿数据库中有妊娠记录的所有居住在苏格兰格兰扁地区的女性。
(A) 母亲结局：先兆子痫、产前出血、先兆流产、胎位异常、引产、器械助产、剖宫产、产后出血及徒手剥离胎盘。(B) 围产期结局：早产、低出生体重、死产、新生儿死亡、5分钟阿氏评分。
回顾性队列研究，将首次妊娠流产的女性与(a) 有一次既往成功妊娠的女性及(b) 初产妇进行比较。从阿伯丁妇产及新生儿数据库中提取1986年至2000年间所有女性的围产期结局数据。
我们确定了1561例首次流产的女性（孕早期1404例，孕中期157例），10549例有过活产史的女性（A组）和21118例初产妇（B组）。流产组发生先兆子痫（校正比值比3.3，99%可信区间2.6 - 4.6）、先兆流产（校正比值比1.7，99%可信区间1.5 - 2.0）、引产（校正比值比2.2，99%可信区间1.9 - 2.5）、器械助产（校正比值比5.9，99%可信区间5.0 - 6.9）、早产（校正比值比2.1，99%可信区间1.6 - 2.8）和低出生体重（校正比值比1.6，99%可信区间1.3 - 2.1）的风险高于A组。与B组相比，她们发生先兆流产（校正比值比1.5, 99%可信区间1.4 - 1.7）、引产（校正比值比1.3, 99%可信区间1.2 - 1.5）、产后出血（校正比值比1.4, 99%可信区间1.2 - 1.6）和早产（校正比值比1.5, 99%可信区间1.2 - 1.8）的可能性更大。
首次流产与产科并发症风险较高相关。
