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The risk of preterm delivery prior to 34 weeks in women presenting with antepartum haemorrhage of unknown origin
Author(s) -
Yeung Sik Wing,
Tam Wing Hung,
Cheung Rachel Y.K.
Publication year - 2012
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2011.01401.x
Subject(s) - medicine , gestation , obstetrics , risk factor , gestational age , hazard ratio , logistic regression , preterm delivery , pregnancy , gynecology , confidence interval , genetics , biology
Background The management of antepartum haemorrhage of unknown origin ( APHUO ) remote from term remains controversial. Aim To determine the rate and risk factors in predicting preterm delivery among women presenting with APHUO before 34 weeks of gestation. Methods All singleton pregnancies with the first episode of APHUO before 34 weeks of gestation who delivered between J anuary 1995 and D ecember 2004 were reviewed. The predictability of risk factors was assessed by both univariate and multivariate analysis. The cumulative rates of preterm delivery prior to 34 weeks were compared by using the K aplan– M eier survival analysis and log‐rank test between those with and those without risk factors. Results The rates of preterm delivery prior to 34 and 37 weeks of gestation were 7.3 and 17%, respectively. Uterine contractions, persistent bleeding, two or more episodes of APHUO and a history of spontaneous preterm deliveries were significant risk factors for preterm birth prior to 34 weeks in a multivariate logistic regression. Women with one risk factor had a hazard ratio of 5.5 (95% CI : 3.2–9.6) in having preterm delivery prior to 34 weeks compared with those without risk factors, whereas women with any two risk factors had a hazard ratio of 5.2 (95% CI : 2.1–12.9) compared with those with one risk factor. Conclusions APHUO prior to 34 weeks of gestation is associated with three to fivefold increased risk of preterm delivery. Identification of several risk factors could further help to predict early preterm delivery and appropriate triage management.