A comparative study of pregnancy outcomes among women with and without threatened miscarriage in the first trimester in Abakaliki Southeast Nigeria

Abstract

Background:Threatened miscarriage is the commonest complication of pregnancy and has been aBackground: Threatened miscarriage is the commonest complication of pregnancy and has been associated with adverse pregnancy outcomes. Therefore, the aim of this study is to determine the association between threatened miscarriage and adverse maternal and perinatal outcomes.Methods: This was a retrospective case-control study undertaken at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki. The study involved 228 women presenting with threatened miscarriage in the first trimester and 228 asymptomatic matched controls. The statistical analysis was done using Epi info version 7.1.5, March 2015 (CDC, Atlanta, Georgia, USA).Results: Women with threatened miscarriage were more likely to have preterm delivery (OR = 7.1, 95% CI = 3.51-14.32, P <0.0001), placenta praevia (OR = 2.4, 95% CI = 1.13 - 5.26, P = 0.03), placental abruption (OR = 3.6, 95% CI = 1.40 - 9.03, P = 0.01) and retained placenta (OR = 2.9, 95% CI = 1.18 - 6.97, P = 0.02). Similarly, women with first trimester threatened miscarriage were more likely to develop postpartum haemorrhage (OR = 2.4, 95% CI = 1.17 - 5.06, P = 0.02). There was no significant differences in the stillbirth rate, Apgar scores at 5 minutes less than 7, admission into neonatal intensive care unit and early neonatal death. Threatened miscarriage was associated with intrauterine growth restriction (OR = 3.5, 95% CI = 1.77 - 6.88, P <0.0001) and low birth weight <2.kg (OR = 3.2, 95% CI = 1.33 - 7.69, P = 0.01).Conclusions: Women with threatened miscarriage in the first trimester are at increased risk of adverse pregnancy outcomes and the risk factors should be taken into consideration when deciding upon antenatal surveillance and management of their pregnancies.

Obstetric Outcomes in Women with Threatened Abortion

“…In contrast to our results, Nwafor et al, 2019 reported that the two study groups had been matched with no significant difference in mean age and body mass index (BMI) between ladies with and without 1st trimester threatened miscarriage.…”

“…Abd-Elaziz et al, 15 discovered a statistically significant difference between patients and control in terms of PPROM, abortion, and preterm labor. Furthermore, 16 demonstrated that women who were threatened with abortion were more likely to give birth prematurely. (OR = 7.1, 95% CI = 3.51-14.32, P < 0.0001), placenta praevia (OR = 2.4, 95% CI = 1.13-5.26, P = 0.03), placental abruption (OR = 3.6, 95% CI = 1.40-9.03, P = 0.01) and retained placenta (OR = 2.9, 95% CI = 1.18-6.97, P = 0.02).…”

Maternal complications in women presenting with first trimester threatened miscarriage.

“…Systemic review by Saraswat et al concluded that pregnancies complicated by threatened miscarriage had 1.5 -4.5 times increased risk of preterm birth than controls. Almost 3 times higher frequency of pretermbirth 12 found in our study was in accordance with Saraswat et al, Nwafor et al and weiss et al 8,11,16 In a study on threatened miscarriage by Haleema et al preterm birth frequency was 17.1% that was lower than our results. 17 The discrepancy could be related to variation in other factors like difference in age, parity, social factors, co morbid, blood loss and sub chorionic haematomas in the two study groups.…”

“…Literature showed that pregnancies complicated by threatened miscarriage had more than 3 times increased risk of placental abruption than controls. 8,11 Frequency of preterm birth was 9.6% in USA 12 and usually one third cases (3-4%) of preterm births got complicated by pre-labour rupture of membranes but frequency of PPROM was found 14% in women who had threatened miscarriage i.e. 3 to 4 times higher than controls.…”

“…Frequency of preterm birth and PPROM was significantly higher in pregnancies survived after threatened miscarriage. 4,8,11 Preventive strategies to reduce the rate of miscarriage, hypertensive disorder of pregnancy including pre eclampsia, placental abruption and preterm birth are required in order to improve fetomaternal outcome. Identification of "high risk" population is important for fetomaternal surveillance in pregnancy.…”