scholarly journals Clinical characteristics of pregnant women with COVID-19 in Japan: a nationwide questionnaire survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tatsuya Arakaki ◽  
Junichi Hasegawa ◽  
Akihiko Sekizawa ◽  
Tomoaki Ikeda ◽  
Isamu Ishiwata ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Early Pregnancy ◽  
Screening Test ◽  
Universal Screening ◽  
Clinical Characteristics ◽  
Severe Infection ◽  
Late Pregnancy ◽  
Maternal Characteristics ◽  
Route Of Infection ◽  
Positive Rate

Abstract Background Few reports have presented an overall view of pregnant women with coronavirus disease 2019 (COVID-19) across an entire country and throughout the entire gestation period. Furthermore, no such reports are available for Japan. We examined the clinical characteristics and outcomes of pregnant women with COVID‑19 on a national scale in Japan. Methods A nationwide questionnaire-based survey for all 2,185 maternity services in Japan was conducted between July and August 2020. Information regarding maternal characteristics and epidemiological, clinical, treatment, and perinatal outcomes of pregnant women diagnosed with COVID-19 between 16 January and 30 June 2020 were collected. Main outcome measures were incidence of pregnant women with COVID-19 and infant infection, positive rate of the universal screening test for asymptomatic pregnant women, identification of infection route and rates of maternal death, and severe cases. Results Responses from 1,418 institutions were assessed (65% of all delivery institutions in Japan). Seventy-two pregnant women were reported to have been diagnosed with COVID-19. The positive rate of the universal screening test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among asymptomatic pregnant women was 0.03% (2/7428). The most common route of infection was familial (57%). Fifty-eight pregnant women with COVID-19 were symptomatic, of whom five (8.6%) had a severe infection and one died (a tourist). Severe respiratory symptoms, oxygen administration, and pneumonia were frequently reported in the third trimester and postpartum period compared with in early pregnancy (22.2% vs 2.5% [P = 0.03], 38.9% vs 7.5% [P = 0.01], and 50.0% vs 7.5% [P < 0.001], respectively). All pregnant women with COVID-19 underwent caesarean sections, regardless of symptoms. There were no SARS-CoV-2 transmissions to newborns. Conclusions In Japan, the number of cases of COVID-19 infection in pregnant women is very low. Compared with early pregnancy, late pregnancy may be a risk factor for exacerbation of symptoms and familial transmission is the most common route of infection. The importance of infection prevention should be emphasised, especially in women in late pregnancy, their families, and any cohabitants.

scholarly journals Clinical Characteristics of Pregnant Women With COVID-19 In Japan: A Nationwide Questionnaire Survey

2021 ◽  
Author(s):  
Tatsuya Arakaki ◽  
Junichi Hasegawa ◽  
Akihiko Sekizawa ◽  
Tomoaki Ikeda ◽  
Isamu Ishiwata ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Early Pregnancy ◽  
Screening Test ◽  
Universal Screening ◽  
Clinical Characteristics ◽  
Severe Infection ◽  
Late Pregnancy ◽  
Maternal Characteristics ◽  
Route Of Infection ◽  
Positive Rate

Abstract Background: Few reports have presented an overall view of pregnant women with coronavirus disease 2019 (COVID-19) across an entire country and throughout the entire gestation period. Furthermore, no such reports are available for Japan. We examined the clinical characteristics and outcomes of pregnant women with COVID‑19 on a national scale in Japan.Methods: A nationwide questionnaire-based survey for all 2,185 maternity services in Japan was conducted between July and August 2020. Information regarding maternal characteristics and epidemiological, clinical, treatment, and perinatal outcomes of pregnant women diagnosed with COVID-19 between 16 January and 30 June 2020 were collected. Main outcome measures were incidence of pregnant women with COVID-19 and infant infection, positive rate of the universal screening test for asymptomatic pregnant women, identification of infection route and rates of maternal death, and severe cases.Results: Responses from 1,418 institutions were assessed (65% of all delivery institutions in Japan). Seventy-two pregnant women were reported to have been diagnosed with COVID-19. The positive rate of the universal screening test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among asymptomatic pregnant women was 0.03% (2/7428). The most common route of infection was familial (57%). Fifty-eight pregnant women with COVID-19 were symptomatic, of whom five (8.6%) had a severe infection and one died (a tourist). Severe respiratory symptoms, oxygen administration, and pneumonia were frequently reported in the third trimester and postpartum period compared with in early pregnancy (22.2% vs 2.5% [P=0.03], 38.9% vs 7.5% [P=0.01], and 50.0% vs 7.5% [P<0.01], respectively). All pregnant women with COVID-19 underwent caesarean sections, regardless of symptoms. There were no SARS-CoV-2 transmissions to newborns.Conclusions: In Japan, the number of cases of COVID-19 infection in pregnant women is very low. Compared with early pregnancy, late pregnancy may be a risk factor for exacerbation of symptoms and familial transmission is the most common route of infection. The importance of infection prevention should be emphasised, especially in women in late pregnancy, their families, and any cohabitants.Trial registration: None

scholarly journals Sleep Patterns in Pregnant Women with Obesity Differentially Affect Energy Intake and Metabolic Health

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 984-984
Author(s):  
Emily Flanagan ◽  
Abby Altazan ◽  
Jasper Most ◽  
Robbie Beyl ◽  
Daniel Hsia ◽  
...  
Keyword(s):  
Weight Gain ◽  
Pregnant Women ◽  
Energy Intake ◽  
Early Pregnancy ◽  
Late Pregnancy ◽  
Sleep Time ◽  
Metabolic Health ◽  
Sleep Patterns ◽  
Gestational Weight ◽  
Gain Energy

Abstract Objectives During pregnancy, altered glucose kinetics coupled with disrupted sleep increase the risk for adverse metabolic health outcomes. The aim of this prospective, observational study in pregnant women with obesity was to 1) examine sleep patterns in early and late pregnancy; and 2) identify how changes in sleep patterns impact gestational weight gain, energy intake and metabolic health. Methods In 52 healthy pregnant women with obesity (27.4 ± 0.6 y; BMI: 36.3 ± 0.7 kg/m,2), energy intake (intake-balance method), and changes in weight, fasting glucose, insulin, lipids and habitual sleep (5 consecutive nights via wrist worn accelerometer) were assessed from early (13,0–15,6 weeks) to late (35,0–36,6) pregnancy. A change to habitual sleep parameters (increase or decrease) was defined as ± one-half of the standard deviation of the 5-day measurement in early pregnancy. Results Results In early pregnancy, time spent in bed (TIB) was 9.40 ± 0.13 h and varied 1.61 ± 0.11 h across the 5 nights. Total sleep time (TST) and sleep efficiency (SE) significantly declined from early to late pregnancy 7.05 ± 0.13 h to 6.46 ± 0.15 h (P &lt; 0.001) and 76 ± 0.1% to 71 ± 0.2% (P &lt; 0.001), respectively. Women who increased TIB (11 of 52) had a significant decrease in plasma glucose −11.6 ± 4.3% (P &lt; 0.01) and a trend towards lower insulin (−57.8 ± 33.5%; P = 0.09) and HOMA-IR (−72.4 ± 37.3%; P = 0.058) across pregnancy compared to women who decreased their TIB (13 of 52). Women who increased TIB had a significantly lower daily energy intake (−540 ± 163 kcal; P &lt; 0.01) and tended to have less gestational weight gain (−146.7 ± 87.6 g/wk; P = 0.10). There was no difference in weight gain, energy intake or plasma markers between women who increased or decreased TST or SE. Conclusions Although sleep time and sleep quality decline throughout pregnancy, TIB had the greatest impact on metabolic health in pregnant women with obesity. Women spending more TIB consumed fewer calories. Our data suggest that the relationship between glucose metabolism and sleep during pregnancy is at least in part explained by lower energy intakes, possibly due to shorter eating windows. Studies that manipulate the eating window, independent of sleep timing are needed to understand the benefits to metabolic health for women during pregnancy. Funding Sources National Institutes of Health [R01DK099175].

Changes in baroreceptor sensitivity for heart rate during normotensive pregnancy and the puerperium

2000 ◽  
Vol 98 (3) ◽  
pp. 259-268 ◽  
Author(s):  
Melanie J. BLAKE ◽  
Allison MARTIN ◽  
Brad N. MANKTELOW ◽  
Charles ARMSTRONG ◽  
Aidan W. HALLIGAN ◽  
...  
Keyword(s):  
Heart Rate ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
High Frequency ◽  
Post Partum ◽  
Late Pregnancy ◽  
Late Gestation ◽  
Control Group ◽  
Pulse Interval ◽  
Normotensive Pregnancy

Normal pregnancy is associated with marked changes in cardiovascular haemodynamics, which in part may be due to changes in autonomic control mechanisms. Baroreflex sensitivity for heart rate (BRS) was calculated in the supine and standing positions using power spectral analysis of pulse interval (PI) and systolic blood pressure (SBP) in 16 normotensive pregnant women and 10 normotensive non-pregnant controls. The pregnant women were studied on three occasions during their pregnancy (early, mid- and late gestation) and once during the puerperium. Supine total SBP variability increased between early and late pregnancy by 79% [95% confidence intervals (CI) 30%, 145%; P < 0.001], and supine high-frequency PI variability decreased by 75% (CI 51%, 88%; P < 0.001). Supine BRS fell by 50% (P < 0.001), with values returning to early-pregnancy levels in the puerperium, which were similar to those recorded in the control group. Standing SBP variability and BRS values were unchanged during pregnancy and post partum. The low/high frequency ratio of PI variability, taken as a surrogate measure of sympathovagal balance, increased by 137% (CI 42%, 296%; P < 0.01) in the supine but not the standing position from early to late pregnancy. This was due to a decrease in high-frequency variability rather than to an increase in low-frequency variability, suggesting that these changes may have been due to vagal withdrawal rather than increased sympathetic activity. Normotensive pregnancy is associated with a marked decrease in supine BRS, although the exact mechanisms for these changes remain unclear. Further studies are required to define whether changes in BRS and sympathovagal tone in early pregnancy can be used to predict the onset of pregnancy-induced hypertension.

Second Trimester Screening of Preeclampsia Using Maternal Characteristics and Uterine and Ophthalmic Artery Doppler

2016 ◽  
Vol 39 (02) ◽  
pp. 190-197 ◽  
Author(s):  
Paulo Praciano de Souza ◽  
Júlio Gurgel Alves ◽  
Sammya Bezerra Maia e Holanda Moura ◽  
Edward Araujo Júnior ◽  
Wellington Martins ◽  
...  
Keyword(s):  
Pregnant Women ◽  
False Positive ◽  
Ophthalmic Artery ◽  
False Positive Rate ◽  
Categorical Variables ◽  
Second Trimester ◽  
Maternal Characteristics ◽  
Maternal Risk ◽  
Second Trimester Screening ◽  
Positive Rate

Abstract Purpose To establish the performance of a multi-parametric test including maternal risk factors and maternal uterine and ophthalmic artery Doppler in the second trimester of pregnancy for the prediction of preeclampsia (PE). Materials and Methods We performed a prospective observational cohort study with pregnant women who underwent a second trimester morphology scan. Maternal uterine and ophthalmic artery Doppler examinations were performed in 415 singleton pregnancies between 18 and 23 weeks of gestation. Additional history was obtained through participant questionnaires, and follow-up occurred to the time of discharge post-delivery. The control and PE groups were compared to continuous variables using the Kruskal-Wallis test and to categorical variables using the Chi-square and Fisher exact tests. Univariate and multivariate logistic regression analyses were performed to determine the best model for the prediction of PE. Results 40 (9.6 %) pregnant women developed PE. We observed significant differences in the body mass index (BMI) (p < 0.001), parity (p < 0.001), mean arterial pressure (MAP) (p < 0.001), and pulsatility index (PI) of uterine artery Doppler (p < 0.001) between PE and control groups. The best model for the prediction of PE included maternal characteristics, MAP, maternal uterine and ophthalmic artery Doppler with area under receiver operating characteristics (ROC) curve of 0.710 (95 % confidence interval, 613 – 0.807) with a sensitivity of 45 % to a false-positive rate of 10 % and 35 % to a false-positive rate of 5 %. Conclusion Maternal ophthalmic artery Doppler did not promote a significant increase in the PE detection rate during the second trimester scan.

scholarly journals The erythrocyte incorporation of absorbed non-haem iron in pregnant women

2001 ◽  
Vol 86 (3) ◽  
pp. 323-329 ◽  
Author(s):  
Paul G. Whittaker ◽  
Jon F.R. Barrett ◽  
Tom Lind
Keyword(s):  
Pregnant Women ◽  
Early Pregnancy ◽  
Oral Absorption ◽  
Late Pregnancy ◽  
Late Gestation ◽  
Stable Isotope Ratios ◽  
Early Gestation ◽  
Haem Iron ◽  
In Pregnancy ◽  
High Absorption

Studies of Fe absorption in pregnancy often make unfounded assumptions of erythrocyte incorporation. Therefore, we measured the absorption and utilisation of Fe during early and late pregnancy by the erythrocyte incorporation of two stable isotopes. 8·5 mg57Fe (oral) and 0·5 mg58Fe (intravenous) were given to five non-pregnant women, to five women in early gestation (12 weeks) and five women in late gestation (36 weeks). The stable isotope ratios in whole blood 14 d later were measured by MS. Together with estimation of body Fe mass, this enabled the calculation of Fe absorption and erythrocyte incorporation. In non-pregnant women, Fe absorption averaged 20·3 (range 10·2–34·3) %. It was not significantly different in early pregnancy (11·8 (range, 4·4–24·8) %), but during late pregnancy Fe absorption increased to 59·0 (range 38·2–77·2) %. All non-pregnant and early-pregnancy subjects had normal Fe status, but two women in late pregnancy had evidence of Fe insufficiency. During early and late pregnancy, mean erythrocyte incorporation was 63·4 (SD 12·1) % AND 71·0 (sd 10·4) % respectively, significantly reduced (P=0·003) compared with non-pregnant subjects (90·1 (sd 6·0) %). Decreased erythrocyte incorporation of absorbed Fe in early pregnancy is compatible with reduced Fe demand and low oral absorption. However, during late pregnancy decreased erythrocyte incorporation associated with high absorption and Fe insufficiency is different from the high erythrocyte incorporation which occurs in non-pregnant Fe-deficient women. This suggests that part of the aetiology of Fe deficiency during pregnancy may be the reduction of Fe utilisation.

scholarly journals PERBEDAAN ANTARA KUALITAS HIDUP IBU PADA PERIODE KEHAMILAN AKHIR DAN NIFAS AWAL DI KOTA YOGYAKARTA

2021 ◽  
Vol 12 (1) ◽  
pp. 65-76
Author(s):  
Fitra Duhita ◽  
Tifa Pascariyanti Sujarwanta ◽  
Indriana Widya Puspitasari
Keyword(s):  
Quality Of Life ◽  
Pregnant Women ◽  
Late Pregnancy ◽  
Cross Sectional ◽  
Maternal Characteristics ◽  
Pregnancy And Postpartum ◽  
The Difference ◽  
Postpartum Mothers ◽  
One Way Anova

Abstract   Background: The success in providing care to the mother during pregnancy and postpartum period is determined by the ability to provide comprehensive care. The pregnancy and postpartum comprehensive care’s needs can be seen through the measurement of quality of life. Objective: To find out the differences quality of life of between mother in late pregnancy and early puerperium, in terms of analysis of maternal characteristics and mean scores from each domain of quality of life. Method: This study uses a cross-sectional design to the 120 pregnant women and 102 postpartum mothers. The data was collected in September until November 2019, at three Puskesmas Rawat Inap in Kota Yogyakarta. The data collection tool used the Indonesian version of the WHOQOL BREF questionnaire, and analyzed with the One Way Anova test and the Manova test. Results: The results showed that the characteristics associated with quality of life were the level of education of pregnant women (to all domains of quality of life) and parity of pregnant women (to the domain of physical). The quality of life scores of postpartum mothers compared with pregnant women in all domains, consistently showed that had lower mean scores, but the difference was not statistically significant. Conclusion: The quality of life between mother in late pregnancy and early puerperium was relatively equal, with lower tendency in early puerperium mother.   Keywords: quality of life, pregnancy, childbirth   Abstrak   Latar belakang: Keberhasilan dalam memberikan asuhan kepada ibu pada periode kehamilan dan nifas ditentukan dari kemampuan memberikan asuhan pasien/klien secara komprehensif. Penilaian kebutuhan ibu hamil dan nifas terhadap asuhan yang komprehensif dapat dilihat melalui hasil pengukuran kualitas hidup. Tujuan: Mengetahui perbedaan kualitas hidup ibu hamil dan nifas, ditinjau dari analisis karakteristik ibu dan rerata skor dari masing-masing domain kualitas hidup. Metode: Penelitian ini menggunakan desain potong lintang. Sampel pada penelitian ini adalah 120 ibu hamil dan 102 ibu nifas. Pengambilan data dilakukan pada bulan September hingga November 2019, pada tiga Puskesmas Rawat Inap di Kota Yogyakarta. Alat pengumpulan data menggunakan kuisioner WHOQOL BREF versi Indonesia. Data yang telah diperoleh dianalisis dengan uji one way Anova dan uji Manova. Hasil: Hasil penelitian menunjukkan bahwa karakteristik yang berhubungan dengan kualitas hidup adalah tingkat pendidikan ibu hamil (terhadap seluruh domain kualitas hidup) dan paritas ibu hamil (terhadap domain kesehatan fisik). Rerata skor kualitas hidup pada ibu nifas dibandingkan dengan kualitas hidup ibu hamil secara konsisten pada seluruh domain menunjukkan nilai yang lebih rendah, namun perbedaan tersebut tidak bermakna secara statistik. Kesimpulan: Kualitas hidup ibu hamil dan ibu nifas relatif sama dengan kecenderungan lebih rendah pada kualitas hidup ibu nifas   Kata kunci: kualitas hidup, hamil, nifas

scholarly journals Thyroxine Supplementation in Pregnant Women After Thyroidectomy for Thyroid Cancer and Neonatal Birth Weight

2021 ◽  
Vol 12 ◽  
Author(s):  
Zheng Ding ◽  
Fei Guo ◽  
Yulai Zhou ◽  
Xiaoyi Huang ◽  
Zhiwei Liu ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Birth Weight ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Late Pregnancy ◽  
Thyroid Stimulating Hormone ◽  
Control Group ◽  
Inverse Association ◽  
Neonatal Birth Weight ◽  
Maternal Thyroid

Patients are often supplemented with a sufficient dose of thyroxine after thyroidectomy for thyroid cancer. However, the influence of thyroxine supplementation on fetal growth in pregnant women after thyroidectomy for thyroid cancer remains unclear. The aim of this study was to investigate the effect of thyroxine supplementation on neonatal birth weight. This cohort study included 49,896 pregnant women (278 patients with a history of thyroidectomy for thyroid cancer and 39,363 control cases after exclusion). Thyroid parameters were examined in pregnant women and their newborns. The associations between maternal thyroid function and neonatal birth weight and small for gestational age were studied using regression analyses. In the levothyroxine supplementation group, free thyroxine (FT4) levels were significantly higher in both early pregnancy (P &lt; 0.001) and late pregnancy (P &lt; 0.001) groups than in the control group. Furthermore, levels of neonatal thyroid stimulating hormone (P = 0.032) and birth weight (P = 0.043) were significantly lower than those in the control group. We also observed a significant inverse association between maternal FT4 levels in early pregnancy and neonatal birth weight (P=0.028), especially in male newborns (P=0.036). In summary, after thyroidectomy for thyroid cancer, a sufficient dose of thyroxine supplementation in early pregnancy is significantly associated with reduced birth weight and may need to be monitored.

scholarly journals Lactose digestion in pregnant African-Americans

2003 ◽  
Vol 6 (8) ◽  
pp. 801-807 ◽  
Author(s):  
David M Paige ◽  
Frank R Witter ◽  
Yvonne L Bronner ◽  
Lisa A Kessler ◽  
Jay A Perman ◽  
...  
Keyword(s):  
African American ◽  
African Americans ◽  
Pregnant Women ◽  
African American Women ◽  
Early Pregnancy ◽  
Lactose Intolerance ◽  
Late Pregnancy ◽  
American Women ◽  
African American Population ◽  
The Status

AbstractObjective:This paper reports on the status of lactose digestion during early and late pregnancy and at 8 weeks postpartum in an African-American population. The hypothesis is that lactose digestion and milk tolerance do not change throughout pregnancy anddo not differ from those of non-pregnant African-American women.Design and subjects:This longitudinal study determined lactose digestion after ingesting 240 ml of 1% fat milk containing 12g of lactose at: (1) early pregnancy, prior to 16 weeks (n = 148); (2) late pregnancy, 30–35 weeks (n = 77); and (3) 8 weeks postpartum (n = 93). One hundred and one comparably matched non-pregnant African-American women served as controls.Results:Prevalence of lactose digestion, as measured by breath hydrogen, was 80.2% in the control women, 66.2% in early pregnancy, 68.8% in late pregnancy and 75.3% postpartum. The prevalence of women reporting symptoms was approximately 20% regardless of lactose absorption status. However, the control women reported significantly more symptoms than did the pregnant women.Conclusions:This study indicates that there is no significant change in lactose digestion during pregnancy. The prevalence of lactose intolerance for the pregnant African-American women studied is similar to that for non-pregnant African-American women and similar to previous prevalence reports in adult African-Americans. There was no change in the tolerance of lactose noted during pregnancy in these women. There were, however, fewer symptoms reported by the lactose-maldigesting pregnant women.

scholarly journals Comparison of urinary 5-L-oxoproline (L-pyroglutamate) during normal pregnancy in women in England and Jamaica

1997 ◽  
Vol 77 (2) ◽  
pp. 183-196 ◽  
Author(s):  
Alan A Jackson ◽  
Chandarika Persaud ◽  
Geoff Werkmeister ◽  
Irene S. M McClelland ◽  
Asha Badaloo ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Late Pregnancy ◽  
Normal Pregnancy ◽  
Progressive Increase ◽  
Significant Difference

Urinary 5-L-oxoproline was measured during normal pregnancies in Southampton, England and Kingston, Jamaica. The CV of 5-L-oxoproline excretion in urine, determined over 7 d in a non-pregnant woman and three pregnant women, was 10–36%. Compared with non-pregnant women, urinary 5-L-oxoproline increased three to four times from early pregnancy in women in Southampton, a highly significant difference, and remained elevated at similar levels during mid and late pregnancy. For women in Kingston, the excretion of 5-L-oxoproline was similar to that of Southampton women in the non-pregnant group and during early pregnancy. However, there was a progressive increase in the excretion of 5-L-oxoproline as pregnancy advanced and by late pregnancy excretion was from three to ten times greater than the average for the non-pregnant women. There was a significant difference between the women in Southampton and the women in Kingston during mid and late pregnancy, with women in Kingston excreting twice as much 5-L-oxoproline during late pregnancy. If the excretion of 5-L-oxoproline is a measure of glycine insdciency, the results would indicate that in some pregnancies the ability of the mother to provide glycine for herself and the developing fetus is marginal or inadequate and the constraint appears more marked in Jamaica than in England.

scholarly journals Maternal and neonatal outcomes of repeated antepartum bleeding in 493 placenta previa cases: a retrospective study

2020 ◽  
Author(s):  
Jiang ziyan ◽  
shiyun huang ◽  
qing zuo ◽  
zhiping ge ◽  
hongmei lu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Elective Surgery ◽  
Placenta Previa ◽  
Late Pregnancy ◽  
Neonatal Outcomes ◽  
Maternal Characteristics ◽  
Increased Risk ◽  
History Of ◽  
Nicu Admission

Abstract Background Placenta previa (PP) is a serious complication of late pregnancy. Exploring the effect of antepartum bleeding caused by PP on pregnancy outcomes is very important.Methods We retrospectively analyzed 493 women complicated with PP. Patients were divided into antepartum repeated bleeding and non-bleeding groups. Maternal characteristics and pregnancy outcomes were compared.Results The risk of antepartum hemorrhage was 2.038 times higher when gravidity was 5 (95% CI 1.104 ~ 3.760, P = 0.023). Pregnant women with a history of more than three intrauterine procedures had a 1.968 times higher risk of antepartum hemorrhage (95% CI 1.135 ~ 3,412, P = 0.016) compared to pregnant women without any intrauterine procedures. The risk of antepartum bleeding was found to be decreasing with the pregnancy advancing; When the placenta edge was noted to be over cervival os, the risk of antepartum bleeding was 4.385-fold than the low-lying plcaenta cases (95%CI2.454ཞ8.372,P = 0.000). In the respect of maternal outcomes, the repeated bleeding group, the risk of emergency surgery was 7.213 times higher than elective surgery (95% CI 4.402ཞ11.817, P = 0.000). As for the neonatal outcomes, the risk of asphyxia was 2.970 times and the risk of NICU admission was 2.542-fold higher in repeated bleeding group compared to non-bleeding group, respectively.Conclusions Obstetricians should be aware of the increased risk of antepartum bleeding especially for ≤ 34 weeks and placenta edge over cervical os PP patients, they have a higher risk of antepartum bleeding. These women have higher possibility of emergency c-section and need preterm newborn resuscitation.

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