EARLY MORBIDITY AND NEURODEVELOPMENTAL OUTCOME IN LOW-BIRTH-WEIGHT INFANTS BORN AFTER 3RD TRIMESTER BLEEDING

Neonatal mortality, morbidity, and neurodevelopmental sequelae were co mpared between a consecutive series of 77 liveborn, low-birthweight (l ess than 2500 g) infants delivered after third trimester bleeding and 154 appropriate control infants of similar gestational age. Infants bo rn after abruptio placentae had lower Apgar scores at 1 minute and hig her rates of acidosis in comparison with control infants. In multivari ate analysis, the infants in this group had higher risks of severe int raventricular hemorrhage and poor outcome (neonatal death or cerebral palsy) in comparison with control infants. In placenta previa, the inf ants had a higher prevalence of respiratory distress syndrome, whereas unclassified antepartum bleeding was associated with a high rate of n eonatal hypoglycemia. After adjustment, by logistic regression analysi s, for the effect of confounding factors (gestational age, birthweight , social class, and education of the mother), the risk of minor infant neurodevelopmental abnormalities at 2-year follow-up was increased in infants delivered after total or partial placenta previa or after unc lassified antepartum bleeding. Third trimester bleeding should be cons idered a strong risk factor for both short-term neonatal morbidity and subsequent infant neurodevelopmental impairment in the low-birthweigh t infant population.