OBJECTIVE
This study aimed to investigate the association between early pregnancy with subchorionic
hematoma and preterm delivery and other adverse pregnancy outcomes in singleton pregnancies.
DATA SOURCES
English studies published from 2000 to July 15, 2022 were retrieved from PubMed, Web
of Science, and the Cochrane Library.
STUDY ELIGIBILITY CRITERIA
The inclusion criteria were: singleton pregnancy, subchorionic hematoma, and perinatal
outcomes. Studies including multiple pregnancy, basic molecular studies, case reports
(series), and conference reviews were excluded.
METHODS
Data analysis was mainly conducted with Review Manager (RevMan) and Stata, and the
results were represented with odds ratios and 95% confidence intervals. The methodological
quality of the included studies was evaluated by the Cochrane risk assessment scale.
RESULTS
In total, 370 studies were retrieved from the above databases. Our review included
16 studies and divided them into 2 subgroups: natural pregnancy (12 studies) and assisted
reproductive pregnancy (4 studies). The relevant characteristics of each study were
analyzed in detail. The primary outcome was preterm delivery. The secondary outcomes
were miscarriage, fetal growth restriction, cesarean delivery, and preeclampsia. We
found that subchorionic hematoma in the first trimester was not significantly associated
with preterm delivery (odds ratio, 1.11; 95% confidence interval, 0.82–1.51) or other
adverse outcomes in singleton pregnancy. Regression analysis found that the large
heterogeneity of the included studies might be related to whether the included study
population (early pregnancy with subchorionic hematoma) was complicated with threatened
abortion (P<.05). However, no studies caused large heterogeneity according to sensitivity analysis.
Finally, 15 studies related to preterm delivery did not have publication bias (Egger
test: P=.26). However, subchorionic hematoma in the first trimester was associated with miscarriage
in single pregnancies (natural pregnancy: odds ratio, 3.07; 95% confidence interval,
1.98–4.75; assisted reproductive pregnancy: odds ratio, 1.45; 95% confidence interval,
1.1–1.90).
CONCLUSION
In singleton pregnancy, we found no association between subchorionic hematoma in the
first trimester and preterm delivery. Although there was a correlation with miscarriage,
the possible gestational age of miscarriage was not stated. More studies are needed
to further address the herein posed research questions.
Key words
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Article info
Publication history
Published online: October 31, 2022
Accepted:
October 24,
2022
Received in revised form:
October 21,
2022
Received:
September 12,
2022
Footnotes
The authors report no conflict of interest.
The authors report no sources of financial support.
This study was registered on the International Prospective Register of Systematic Reviews (registration date and number: July 29, 2022; CRD420422347271)
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