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Please cite this paper as: Gargano J, Holzman C, Senagore P, Reuss M, Pathak D, Williams M, Fisher R. Evidence of placental haemorrhage and preterm delivery. BJOG 2010;117:445–455. Objective To evaluate evidence of placental haemorrhage (PH) obtained through maternal interviews, patient charts and placental pathology examinations as potential indicators of a ‘bleeding pathway’ to preterm delivery (PTD). Design Prospective cohort. Setting Fifty-two clinics in five communities in Michigan, USA (1998–2004). Population A subset (n = 996) of cohort participants with complete placental pathology data. Methods First-trimester bleeding and placental abruption were ascertained by mid-trimester interviews and chart review, respectively. Disc-impacting blood clot was defined as a gross placental examination finding of a blood clot impacting adjacent tissue. Microscopic haemorrhage was defined as ‘high’ (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. Main outcome measures Preterm delivery and PTD subtypes (i.e. |
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