Elena Dudukina, who defended her PhD thesis today, has conducted four studies on how threatened abortion affects the health of the offspring and the mother.

Threatened abortion (TAB) is vaginal bleeding (VB) before 20 weeks of gestation during a viable intrauterine pregnancy in the absence of cervical dilation. TAB affects up to 30% of clinically recognised pregnancies and at gestational weeks 6-8, it is associated with a 12% increased absolute risk of miscarriage compared with unaffected pregnancies. Despite an established association of miscarriage with maternal mortality and morbidity, there is little data on long-term maternal and child health following a pregnancy affected by TAB.

In the first study, Elena and colleagues investigated the association between in utero exposure to TAB and the risk of neurological and neurodevelopmental disorders in children. In the remaining three studies, they examined the association between VB in pregnancy and subsequent health of the women themselves, as measured by risk of all-cause and cause-specific mortality (study II), risk of diabetes and cardiovascular morbidity (study III), and risk of cancer (study IV). In the studies of women’s outcomes, three comparators were used: 1) women with a VB-unaffected pregnancy ending in a delivery, 2) women with a pregnancy ending in a termination, and 3) women with a pregnancy ending in a miscarriage.

Compared with TAB-unaffected children, TAB-affected children had a greater risk of cerebral palsy, but not of epilepsy or attention-deficit/hyperactivity disorder. Having a VB-affected vs VB-unaffected pregnancy was associated with an increased risk of diabetes type 1 and 2 and multiple cardiovascular conditions in women. However, it did not translate into increased risks of all-cause or natural cause mortality. Elena and colleagues found no association with cancer when comparing women with VB-affected pregnancy to women with VB-unaffected pregnancy, termination, or miscarriage.