{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T16:26:02Z","timestamp":1754151962950,"version":"3.41.2"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2010,1,14]],"date-time":"2010-01-14T00:00:00Z","timestamp":1263427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2010,3]]},"abstract":"<jats:p> <jats:italic>Please cite this paper as:<\/jats:italic> Gargano J, Holzman C, Senagore P, Reuss M, Pathak D, Williams M, Fisher R. Evidence of placental haemorrhage and preterm delivery. BJOG 2010;117:445\u2013455.<\/jats:p><jats:p><jats:bold>Objective\u2002<\/jats:bold> To evaluate evidence of placental haemorrhage (PH) obtained through maternal interviews, patient charts and placental pathology examinations as potential indicators of a \u2018bleeding pathway\u2019 to preterm delivery (PTD).<\/jats:p><jats:p><jats:bold>Design\u2002<\/jats:bold> Prospective cohort.<\/jats:p><jats:p><jats:bold>Setting\u2002<\/jats:bold> Fifty\u2010two clinics in five communities in Michigan, USA (1998\u20132004).<\/jats:p><jats:p><jats:bold>Population\u2002<\/jats:bold> A subset (<jats:italic>n<\/jats:italic>\u2003=\u2003996) of cohort participants with complete placental pathology data.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> First\u2010trimester bleeding and placental abruption were ascertained by mid\u2010trimester interviews and chart review, respectively. Disc\u2010impacting blood clot was defined as a gross placental examination finding of a blood clot impacting adjacent tissue. Microscopic haemorrhage was defined as \u2018high\u2019 (top quintile) scores on an aggregate measure of placental pathology findings suggestive of atypical maternal vessel haemorrhage. These four PH indicators were compared with one another and with risk of PTD assessed by logistic regression analyses.<\/jats:p><jats:p><jats:bold>Main outcome measures\u2002<\/jats:bold> Preterm delivery and PTD subtypes (i.e. &lt;35\u2003weeks, 35\u201336\u2003weeks; spontaneous, medically indicated) compared with term deliveries.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Placental abruption cases had 2.3\u2010fold to 5.5\u2010fold increased odds of the other three PH indicators. Disc\u2010impacting blood clots and microscopic haemorrhage were associated with one another (odds ratio [OR]\u2003=\u20034.6), but not with first\u2010trimester bleeding. In a multivariable model that included all four PH indicators and confounders, risk of PTD\u2003&lt;\u200335\u2003weeks was elevated with first\u2010trimester bleeding (OR\u2003=\u20031.9 [1.0, 3.4]), placental abruption (OR\u2003=\u20035.2 [1.7, 16.2]), disc\u2010impacting blood clots (OR\u2003=\u20032.3 [1.0, 5.0]) and microscopic haemorrhage (OR\u2003=\u20032.4 [1.4, 4.2]).<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Multiple clinical and subclinical PH indicators are associated with PTD, particularly early PTD.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2009.02472.x","type":"journal-article","created":{"date-parts":[[2010,1,14]],"date-time":"2010-01-14T06:28:33Z","timestamp":1263450513000},"page":"445-455","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Evidence of placental haemorrhage and preterm 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