Dataset Information

Intrauterine Hematoma in the First Trimester and Pregnancy Complications: A Systematic Review and Meta-Analysis.

ABSTRACT:

Background

Studies evaluating the relationship between intrauterine hematoma in the first trimester and prenatal complications are conflicting.

Objectives

To evaluate whether intrauterine hematoma identified in the first trimester in women with singleton pregnancies is associated with adverse perinatal outcomes.

Search strategy

A comprehensive literature search of three databases (Embase, PubMed, and Web of Science) was performed up to September 2021.

Selection criteria

Cohort and case-control studies that have evaluated the relationship between intrauterine hematoma identified before 14 gestational weeks and the risk of prenatal complications, in women with a singleton pregnancy.

Data collection and analysis

Two members of our team independently assessed the studies for inclusion, collected the data of interest, and assessed the risk of bias, and calculated pooled odds ratios (ORs) using random-effects models.

Main results

Nine studies, including 1,132 women with intrauterine hematoma and 11,179 controls met the inclusion criteria. Intrauterine hematoma increased the risk of spontaneous abortion [OR 2.15, 95% confidence interval (CI) 1.23-3.75], preterm birth (OR 1.83, 95% CI 1.37-2.43), fetal growth restriction (OR 2.33, 95% CI 1.13-4.83) and placental abruption (OR 3.16, 95% CI 1.23-8.13). No statistically significant association was found between intrauterine hematoma and preeclampsia (OR 1.30, 95% CI 0.87-1.94).

Conclusion

Intrauterine hematoma in the first trimester of pregnancy increases the risk of spontaneous abortion, preterm birth, placental abruption, and fetal growth restriction.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/.

SUBMITTER: Qin ZJ

PROVIDER: S-EPMC9247277 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Microelements involved in the oxidative balance have a significant impact on human health, but their role in pregnancy are poorly studied. We examined the relationships between first trimester levels of selenium (Se), iron (Fe), zinc (Zn), and copper (Cu), as well as maternal characteristics and pregnancy results. The data came from a Polish prospective cohort of women in a single pregnancy without chronic diseases. A group of 563 women who had a complete set of data, including serum microelements in the 10-14th week was examined, and the following were found: 47 deliveries <37th week; 48 cases of birth weight <10th and 64 newborns >90th percentile; 13 intrauterine growth restriction (IUGR) cases; 105 gestational hypertension (GH) and 15 preeclampsia (PE) cases; and 110 gestational diabetes mellitus (GDM) cases. The microelements were quantified using mass spectrometry. The average concentrations (and ranges) of the elements were as follows: Se: 60.75 µg/L (40.91-125.54); Zn: 618.50 µg/L (394.04-3238.90); Cu: 1735.91 µg/L (883.61-3956.76); and Fe: 1018.33 µg/L (217.55-2806.24). In the multivariate logistic regression, we found that an increase in Se of 1 µg/L reduces the risk of GH by 6% (AOR = 0.94; p = 0.004), the risk of IUGR by 11% (AOR = 0.89; p = 0.013), and the risk of birth <34th week by 7% (but close to the significance) (AOR = 0.93; p = 0.061). An increase in Fe of 100 µg/L reduces the risk of PE by 27% (AOR = 0.73; p = 0.009). In the multivariable linear regression, we found negative strong associations between prepregnancy BMI, Se (β = -0.130; p = 0.002), and Fe (β = -0.164; p < 0.0001), but positive associations with Cu (β = 0.320; p < 0.000001). The relationships between Se and maternal age (β = 0.167; p < 0.0001), Se and smoking (β = -0.106; p = 0.011) and Cu, and gestational age from the 10-14th week (β = 0.142; p < 0.001) were also found. Secondary education was associated with Zn (β = 0.132; p = 0.004) and higher education was associated with Cu (β = -0.102; p = 0.023). A higher financial status was associated with Fe (β = 0.195; p = 0.005). Other relationships were statistically insignificant. Further research is needed to clarify relationships between first trimester microelements and pregnancy complications. In addition, attention should be paid to lifestyle-related and socioeconomic factors that affect microelement levels.