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The effects of first-trimester subchorionic hematoma on pregnancy outcomes: a retrospective cohort study

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Although first-trimester subchorionic hematoma (SCH) always concerns expectant parents, its clinical significance remains controversial. This study aimed to examine the relationship between SCH and its association with subsequent miscarriage and other perinatal outcomes in singleton pregnancies.

Methods

We conducted a retrospective cohort study including 43,660 women who underwent routine prenatal care since the first trimester and then were followed up for maternal and neonatal outcomes. SCH was detected in the first-trimester ultrasound examinations. Robust Poisson regression was used to estimate adjusted risk associations of SCH with maternal and neonatal outcomes.

Results

A total of 815 (1.87%) SCH cases were detected in the first-trimester ultrasound examinations. The rate of miscarriage was statistically significantly higher in women with SCH than without [35.21% vs. 23.92%, P < 0.01; adjusted relative risk (RR):1.44, 95% confidence interval (CI): 1.31–1.58]. Subgroup analysis of women with SCH showed a clear trend that the earlier SCH occurred, the higher the risk of miscarriage was [adjusted RR (95% CI) for onset at the gestational weeks of 8–9, 6–7, and < 6 vs. ≥ 10: 1.30 (0.69–2.46), 2.33 (1.28–4.23), and 4.18 (2.30–7.58), respectively; Ptrend < 0.01]. In addition, women with SCH volume ≥ 1 ml showed higher risk than did those with SCH volume < 1 ml [adjusted RR (95% CI) for 1–4.9 ml, and ≥ 5 ml vs. < 1 ml: 1.36 (1.10–1.68) and 1.56 (1.18–2.07), respectively]. There was no statistically significant difference in the rates of other pregnancy outcomes between women with and without SCH.

Conclusions

First-trimester SCH, particularly when characterized by early presence and large size, might significantly increase the risk of miscarriage. Data from this study suggest no associations between SCH and other maternal and neonatal outcomes.

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Availability of data and materials

Datasets obtained and/or analyzed in this study are available from the corresponding author on reasonable request.

Abbreviations

SCH:

Subchorionic hemorrhage

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Acknowledgements

We thank all patients who paid their antenatal care visit in our hospital and all physicians who recorded the data on pregnancies and pregnancy outcomes.

Funding

The study was supported by a grant from the Guangzhou Women and Children’s Medical Center, Guangzhou, China (1600067–04). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Author notes

  1. Chongjuan Gu and Yaojuan He contributed equally as senior authors.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China

    Chongjuan Gu, Yaojuan He, Qingfeng Li & Qingshan Xuan

  2. Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, 9 Jinsui Road, Tianhe District, Guangzhou, 510623, China

    Xiaojun Li & Kuanrong Li

Authors
  1. Chongjuan Gu
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  2. Yaojuan He
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  4. Qingfeng Li
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  5. Qingshan Xuan
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  6. Kuanrong Li
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Contributions

CG and KL drafted the manuscript. CG and YH contributed to the design of the research. KL contributed to the development of the statistical plan and statistical analysis of the data. QL contributed to the conception of the study. XL and QX contributed to data management and prepared the retrospective data for analysis. All authors reviewed, read and approved the final manuscript.

Corresponding author

Correspondence to Kuanrong Li.

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Conflict of interest

All listed authors declare that they have no conflict of interest.

Ethics approval and consent to participate

The study was approved by the Ethical Committee of the Guangzhou Women and Children’s Medical Center. (2020–15001). All methods were carried out in accordance with relevant guidelines and regulations. Ethics approval and consent to participate was waived by the Ethics Committee of Guangzhou Women and Children’s Medical Center due to the retrospective nature of the study.

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Gu, C., He, Y., Li, X. et al. The effects of first-trimester subchorionic hematoma on pregnancy outcomes: a retrospective cohort study. Arch Gynecol Obstet 308, 1159–1164 (2023). https://doi.org/10.1007/s00404-022-06776-x

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  • DOI: https://doi.org/10.1007/s00404-022-06776-x

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