Adverse perinatal and neonatal outcomes in patients with chronic abruption–oligohydramnios sequence

<jats:title>Abstract</jats:title><jats:sec><jats:title>Aim</jats:title><jats:p>Chronic abruption–oligohydramnios sequence (<jats:styled-content style="fixed-case">CAOS</jats:styled-content>) is a clinical condition with lasting vaginal bleeding and oligohydramnios because of chronic placental abruption, which seems to cause preterm labor and neonatal chronic lung disease (<jats:styled-content style="fixed-case">CLD</jats:styled-content>). This prompted us to explore the correlation between perinatal/neonatal outcomes and <jats:styled-content style="fixed-case">CAOS</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Patients with suspected risk of abortion with recurrent vaginal bleeding were divided into <jats:styled-content style="fixed-case">CAOS</jats:styled-content> and non‐<jats:styled-content style="fixed-case">CAOS</jats:styled-content> groups, and we compared the perinatal/neonatal outcomes between these two groups. To examine the impact of chorioamnionitis (<jats:styled-content style="fixed-case">CAM</jats:styled-content>) on the prognosis of <jats:styled-content style="fixed-case">CAOS</jats:styled-content>, we also compared outcomes between the <jats:styled-content style="fixed-case">CAOS</jats:styled-content> group and gestational‐age‐matched preterm labor due to <jats:styled-content style="fixed-case">CAM</jats:styled-content> (<jats:styled-content style="fixed-case">CAM</jats:styled-content> group).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In the <jats:styled-content style="fixed-case">CAOS</jats:styled-content> and non‐<jats:styled-content style="fixed-case">CAOS</jats:styled-content> groups, initial vaginal bleeding was seen at the first trimester. However, its duration was significantly longer in the <jats:styled-content style="fixed-case">CAOS</jats:styled-content> group. Additionally, neonatal birthweight was lower, and small‐for‐gestational‐age (<jats:styled-content style="fixed-case">SGA</jats:styled-content>) incidence was higher in the <jats:styled-content style="fixed-case">CAOS</jats:styled-content> group. <jats:styled-content style="fixed-case">CLD</jats:styled-content> was observed in most infants from <jats:styled-content style="fixed-case">CAOS</jats:styled-content> patients. In the comparison between <jats:styled-content style="fixed-case">CAOS</jats:styled-content> and <jats:styled-content style="fixed-case">CAM</jats:styled-content> groups, birthweight was lower and <jats:styled-content style="fixed-case">SGA</jats:styled-content> incidence was higher in the <jats:styled-content style="fixed-case">CAOS</jats:styled-content> group. Moreover, <jats:styled-content style="fixed-case">CLD</jats:styled-content> incidence and neonatal mortality were significantly higher, despite the lower incidence of severe <jats:styled-content style="fixed-case">CAM</jats:styled-content> in the <jats:styled-content style="fixed-case">CAOS</jats:styled-content> group. Finally, multivariate analysis demonstrated that duration of bleeding was a significant predictive factor for <jats:styled-content style="fixed-case">CAOS</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Our observations demonstrated that patients with <jats:styled-content style="fixed-case">CAOS</jats:styled-content> were a high‐risk group for poor perinatal/neonatal outcomes. Moreover, episodes of recurrent and prolonged uterine bleeding were predictive factors for <jats:styled-content style="fixed-case">CAOS</jats:styled-content>. During the first trimester, prolonged bleeding is an important sign as one symptom of <jats:styled-content style="fixed-case">CAOS</jats:styled-content>.</jats:p></jats:sec>