Association between early pregnancy bleeding and neonatal outcome: a retrospective cohort study from low resource setting.

INTRODUCTION: Early pregnancy bleeding (EPB) is considered as an important risk factor for pregnancy loss. Therefore, the rest of the pregnancy is managed cautiously in order to prevent adverse outcome in these patients. Sri Lanka, although a developing country, maternal and fetal health is maintained as a high standard despite limitations. This study is aimed at analysing association of EPB with neonatal outcomes in a low resource setting.

RESULTS: A total of 238 women were included in this retrospective case-control study, of whom 81 (34%) experienced EPB and 157 (66%) served as matched controls. EPB was significantly associated with lower neonatal birth weight (adjusted OR = 2.44, p = 0.017). The odds of preterm delivery were markedly higher among women with EPB (adjusted OR = 14.34, P = 0.001), though the model fit was marginal. No significant associations were found between EPB and, pregnancy induced hypertension, or gestational diabetes mellitus.

CONCLUSIONS: This study demonstrates a significant association between EPB and low birth weight and strong but model-wise marginal association with preterm delivery, warranting early identification and close antenatal surveillance of pregnancies complicated by early bleeding, especially in resource-limited settings.