ArticleAmerican journal of obstetrics and gynecology2020
Vaginal bleeding and nausea in early pregnancy as predictors of clinical pregnancy loss.
Article in American journal of obstetrics and gynecology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 18 citations in OpenAlex.
- Periconception Maternal-Serum Vitamin D, Vaginal Bleeding, and Subchorionic Hemorrhage in Early Pregnancy.Nutrients · 2026Trial
- Periconception Maternal Vitamin D Status on Nausea and Vomiting Symptoms in Early Pregnancy Among Women with a History of Pregnancy Loss.Nutrients · 2026Trial
- A Scoping Review of 5-HTPharmacoepidemiology and drug safety · 2026Article
- First-Trimester Bleeding and the Risk of Pregnancy Loss in a Prospective Cohort.Obstetrics and gynecology · 2026Article
- A multivariable risk prediction model for pregnancies of uncertain viability without a fetal pole: a prospective cohort study.Frontiers in medicine · 2026Article
- PERİDER-TJOD joint review on threatened abortion and guideline for its treatment.Turkish journal of obstetrics and gynecology · 2025Article
- Vaginal bleeding in early pregnancy at a regional-level emergency department in KwaZulu-Natal.Journal of the colleges of medicine of South Africa · 2025Article
- Variables Associated With Favorable Obstetrical Outcomes in Early Pregnancy Bleeding in the Emergency Department.Cureus · 2024Article
- Predicting risk of the subsequent early pregnancy loss in women with recurrent pregnancy loss based on preconception data.BMC women's health · 2024Article
- Elucidating the role of hepatic enzymes in spontaneous abortion: a Mendelian randomization approach.Frontiers in genetics · 2024Article
- Prevalence and course of pregnancy symptoms using self-reported pregnancy app symptom tracker data.NPJ digital medicine · 2023Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAlthough nausea and vaginal bleeding are commonly experienced in early pregnancy, their prognostic value in predicting clinical pregnancy loss is not well understood.
objectiveThis study aimed to understand whether timing of bleeding and nausea symptoms can be used to predict risk of pregnancy loss among women with ultrasound-confirmed pregnancies. STUDY
designA cohort of 701 women with clinically confirmed pregnancies and 1 to 2 previous pregnancy losses were preconceptionally enrolled in the Effects of Aspirin in Gestation and Reproduction trial (2006-2012). Participants completed daily symptom diaries from 2 to 8 weeks' gestation and were prospectively monitored for detection of pregnancy loss. The risk of pregnancy loss was estimated for each observed bleeding and nausea pattern, and positive and negative predictive values for each pattern were calculated.
resultsAmong 701 women, 211 (30.1%) reported any vaginal bleeding, and 639 (91.2%) reported any nausea. Most bleeding experienced by women was spotting and contained within a single episode. Within 2 to <4, 4 to <6, and 6 to 8 weeks' gestation, vaginal bleeding occurred in 5.9% (41) (5.7% live birth, 7.1% clinical pregnancy loss), 14.6% (102) (13.9% live birth, 18.6% clinical pregnancy loss), and 20.8% (146) (18.4% live birth, 32.4% clinical pregnancy loss) of women, respectively. Within the same gestational periods, nausea was reported in 22.7% (159) (23.2% live birth, 20.4% clinical pregnancy loss), 65.9% (462) (67.5% live birth, 58.4% clinical pregnancy loss), and 87.0% (610) (90.6% live birth, 69.0% clinical pregnancy loss) of women. Women who had bleeding without nausea between 6 and 8 weeks' gestation (3.6% prevalance) had the greatest risk of clinical pregnancy loss (risk difference=56.1%; 95% confidence interval, 37.6-74.7), a positive predictive value of 68.0% (49.7%, 86.3%), negative predictive value of 85.8% (83.2%, 88.4%), positive likelihood ratio of 11.1 (2.04, 20.1), and negative likelihood ratio of 0.86 (0.79, 0.93). Nausea and bleeding are clinical factors that predicted clinical pregnancy loss (area under the curve, 0.87; 95% confidence interval, 0.81-0.88) similar to age, body mass index, blood pressure, and waist-to-hip ratio (area under the curve, 0.81; 95% confidence interval, 0.78-0.88) measured preconceptionally.
conclusionWomen experiencing bleeding without nausea between 6 and 8 weeks' gestation had an increased risk of clinical pregnancy loss. Bleeding and nausea were not predictive risk factors of clinical pregnancy loss prior to 6 weeks' gestation.
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