Adverse pregnancy outcomes are associated with menstrual abnormalities.

Abstract

Background: The association between menstrual characteristics and pregnancy complications is not well understood. We aimed to determine the associations between menstrual characteristics and adverse pregnancy outcomes. Method(s): Cross-sectional survey capturing menstrual cycle, pregnancy and gynaecological condition diagnoses. Differences in age of menarche, period regularity, heaviness, intermenstrual bleeding, clots, spotting and pain were determined between women with adverse pregnancy outcomes (stillbirth, preterm birth, foetal growth restriction (FGR), preeclampsia, antepartum haemorrhage) and those without. Rates and timing of gynaecological disease relative to pregnancy were also determined. Results :232 responses were received; 84 had experienced one or more adverse pregnancy outcomes. There were no significant differences in self-reported menstrual characteristics among women who experienced an adverse pregnancy event compared to those who did not. However, women who had experienced a stillbirth, more frequently reported heavy periods (61% vs. 51%) and intermenstrual bleeding (11.5% vs. 6.1%). Those with FGR reported higher rates of large clots (68% vs. 47%), spotting (16% vs. 7%;) and intermenstrual bleeding (12% vs. 6%) and those with preterm birth reported higher rates of irregular cycles (18% vs. 11%), lighter periods (8% vs. 5%) and spotting (12% vs. 7.4%). Half of women who were diagnosed with endometriosis and all the women with adenomyosis were diagnosed after their first pregnancy. Conclusion(s): While individual characteristics of menstruation were not significantly different, we did identify differences that warrant further investigation. Given the possible link between menstrual symptoms with pregnancy complications, and timing of gynaecological diagnoses, clinicians may need to investigate menstruation earlier than current practice.