Guagua National Colleges

Rep. Eligio Lagman St. Sta. Filomena Rd. Guagua Pampanga

College of Allied Medical Programs
College of Nursing

Mikyla S. Bautista
BSN – 2C
Vaginal bleeding in pregnancy and adverse clinical outcomes: a systematic review and
meta-analysis
Arezoo Karami 2024, et al.

Vaginal bleeding during pregnancy has been recognized as a significant risk factor for
adverse pregnancy outcomes. This study aimed to investigate the association between vaginal
bleeding during the first trimester of pregnancy and clinical adverse effects using a systematic
review and meta-analysis. Vaginal bleeding in the first trimester of pregnancy is associated with
preterm birth, LBW, PROMs, miscarriage, stillbirth, placental abruption and placenta previa.
Therefore, physicians or midwives need to be aware of the possibility of these consequences and
manage them when they occur.

Vaginal bleeding during pregnancy, especially during the first trimester, can lead to
adverse maternal and infant outcomes including placental abruption, premature rupture of
membranes (PROMs), preterm delivery, intrauterine growth restriction (IUGR) and admission to
the neonatal intensive care unit (NICU). Spotting and vaginal bleeding are common during
pregnancy, but they have not been attributed to any specific cause. It has been said that a quarter
of pregnancies are associated with mild to severe vaginal bleeding during the first trimester.
There is a diversity of reports regarding the association between bleeding during pregnancy and
adverse neonatal outcomes, but none of them suggests a causal relationship. Differences in
access to health services during pregnancy, severity and duration of bleeding, urinary tract
infection, education level, causes of bleeding, history of abortion, unwanted pregnancy,
infertility, multiple pregnancies and smoking cessation also influence the above-mentioned
association and can lead to discrepancies in the results of studies. Therefore, identifying the
appropriate and accurate association between bleeding during pregnancy and adverse pregnancy
outcomes requires pooling studies’ results and drawing a more complete picture of factors
affecting pregnancy outcomes.

How will it affect the community in general?

The purpose of this systematic review and meta-analysis was to investigate the link
between vaginal bleeding during the first trimester of pregnancy and clinical outcomes in
mothers and newborns. Bleeding during the first trimester of pregnancy increases the risk of
preterm delivery, PROM, LBW, abortion, stillbirth, placental abruption, and placental previa. As
a result, it is important to determine the reasons of this occurrence and implement adequate
healthcare measures to avoid bleeding during pregnancy, with a particular focus on the adverse
clinical effects. Bleeding during the first trimester of pregnancy causes improper fetal growth
and development. As a result, as a risk factor, it can raise the likelihood of abortion and stillbirth,
which requires careful attention. Stillbirth or miscarriage occurs in 50% of fetuses in women
who have bleeding during pregnancy owing to placental abruption or previa. Also, PROM
caused by bleeding in the first trimester of pregnancy might result in preterm delivery and
miscarriage.