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”’Neonatal uterine bleeding (NUB)”’ also known as ”’neonatal menstruation”’ and ”’false menses”’ is vaginal bleeding that occurs in some female [[neonates]] shortly after birth.<ref name=Menses/> |
”’Neonatal uterine bleeding (NUB)”’ also known as ”’neonatal menstruation”’ and ”’false menses”’ is vaginal bleeding that occurs in some female [[neonates]] shortly after birth.<ref name=Menses/> |
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<ref>{{cite journal|first1=Mariana |last1=Pedro |first2=Marta |last2=Caldas |first3=Jorge |last3=Penas |first4=Anabela |last4=Bicho |doi=10.5455/IJMRCR.172-1658107368|title=Newborn vaginal bleeding – Why to record|journal=|volume=6 |number=21 |pages=36–37 |date=5 January 2023}}</ref> |
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It is different from [[Menstruation|adult menstruation]] as it is characterized by the fall of maternal [[hormones]] after birth, which in turn triggers the shedding of the [[endometrium|uterine lining]]. It is often harmless and occurs in 3–5% of female newborn infants. |
It is different from [[Menstruation|adult menstruation]] as it is characterized by the fall of maternal [[hormones]] after birth, which in turn triggers the shedding of the [[endometrium|uterine lining]]. It is often harmless and occurs in 3–5% of female newborn infants. |
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Revision as of 06:49, 15 October 2025
Uterine bleeding that occurs in newborns
Neonatal uterine bleeding (NUB) also known as neonatal menstruation and false menses is vaginal bleeding that occurs in some female neonates shortly after birth.[1]
[2]
It is different from adult menstruation as it is characterized by the fall of maternal hormones after birth, which in turn triggers the shedding of the uterine lining. It is often harmless and occurs in 3–5% of female newborn infants.
Characteristics
Neonatal uterine bleeding occurs shortly after birth, between 3 to 5 days of infancy. Female infants may experience bleeding for up to 10 days.[1]
It is caused by an exposure of the fetus to the mother’s high level hormones like estrogen and progesterone. After birth the abrupt decrease and withdrawal of these hormones from the fetus affect the developing fetal endometrium, triggering the shedding of the uterus which can cause small vaginal bleeding.[3]However, it is theorized that a mucus plug in the neonate’s cervix can contribute to a “retrograde flux” of endometrial cells into the pelvic cavity, which may contribute to NUB.[4]
NUB is relatively rare despite the high circulating levels of progesterone due to a progesterone resistance present in a majority of neonates.[5]
Occurrence
Neonatal uterine bleeding varies considerably. In a study carried out by Judith Dekker, “the prevalence of visible bleeding ranged from 3.3 to 53.8% and the prevalence of occult bleeding from 25.4 to 96.7%”. NUB occurrence is highest between the 3rd and 7th day of postpartum.[6][7]
According to studies, NUB occurs in approximately 5% of female newborns. While it is rare, biochemical proofs of vaginal bleeding can be found in 25–61% of neonates.[8]
Effects
Studies suggest that the presence of endometrial mesenchymal stem cells (eMSCs) in neonatal uterine blood could lead to early development of endometriosis hypothesizing a link between NUB and accelerated maturation of endometriosis.[9][7] The retrograde flow of endometrial cells during NUB may lead to ectopic endometrial implants in the pelvic cavity that can become active later in life, especially after menarche begins.[10][4]
References
- ^ a b “Vaginal Bleeding in newborns”. Seattle Children’s Hospital. Retrieved 15 October 2025.
- ^ Pedro M, Caldas M, Penas J, Bicho A (5 January 2023). “Newborn vaginal bleeding – Why to record”. 6 (21): 36–37. doi:10.5455/IJMRCR.172-1658107368.
- ^ Kesavan S (June 2024). “Vaginal bleeding in children”. Lerner College of Medicine of Case Western Reserve University.
- ^ a b A Brosens I, J Brosens J, Benagiano G (17 September 2013). “Neonatal uterine bleeding as antecedent of pelvic endometriosis”. Human Reproduction. 28 (11): 2893–2897. doi:10.1093/humrep/det359. PMID 24048011.
- ^ Chiara Luchetti M (2005). “Neonatal Uterine Bleeding: An underestimated clinical sign?”. Academic Journal of Pediatrics and Neonatology. 5 (1): 4661–4662. doi:10.1073/pnas.0501342102. PMC 555712. PMID 15781853.
- ^ Dekker J, Hooijer I, Ket JC, Vejnović A, Benagiano G, Brosens I, et al. (18 January 2021). “Neonatal Uterine Bleedings: An ignored sign but a possible cause of early-onset endometriosis − a systematic review”. Biomed Hub. 6 (1): 6–16. doi:10.1159/000512663. PMC 7991472. PMID 33791312.
- ^ a b Ogawa K, Khan KN, Kuroboshi H, Koshiba A, Shimura K, Tajiri T, et al. (February 2024). “Neonatal uterine bleeding: Risk factors and its association with endometriosis-related symptoms later in life”. European Journal of Obstetrics & Gynecology and Reproductive Biology. 293: 146-155. doi:10.1016/j.ejogrb.2023.12.033. PMID 38199071.
- ^ Puttemans P, Benagiano G, Gargett C, Romero R, Wei Guo S, Brosens I (18 August 2016). “Neonatal Uterine Bleeding as a biomaker for reproductive disorders during adolescence: a worldwide call for systematic registration by nurse midwife”. J Matern Fetal Neonatal Med. 30 (12): 1434–1436. doi:10.1080/14767058.2016.1216540. PMC 5505234. PMID 27454348.
- ^ Ogawa K, Khan KN, Kuroboshi H, Koshiba A, Shimura K, Tajiri T, et al. (19 June 2023). “Is neonatal uterine bleeding responsible for early-onset endometriosis?”. Reproductive Biology and Endocrinology. 21 56. doi:10.1186/s12958-023-01099-1. PMC 10278367. PMID 37337237.
- ^ Marwan H, Sun WG, Benagiano G (26 July 2023). “In Memory of Ivo Brosens: Reflections on the Pathophysiology of Neonatal Uterine Bleeding”. Gynecol Obstet Invest. 88 (5): 257–266. doi:10.1159/000533123. PMID 37494891.
