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DOI: 10.1055/s-0028-1103156
Comparison of Maternal Risk Factors between Placental Abruption and Placenta Previa
Publication History
Publication Date:
19 November 2008 (online)
ABSTRACT
The purpose of this study was to compare risk factors between placental abruption and placenta previa among primiparous and multiparous singleton pregnancies. We analyzed data from a population-based retrospective cohort with singleton pregnancies in the United States for 1995 to 2000. Maternal risk factors for placenta previa and placental abruption were examined using multiple logistic regressions. A total of 5,630,854 primiparous and 11,026,768 multiparous singleton pregnancies were available for final analyses after excluding subjects with missing information on outcomes or important exposures. Placental abruption was recorded in 4.8 per 1000 primiparous singleton births and 5.9 per 1000 multiparous singleton pregnancies. The occurrence of placenta previa was 1.9 per 1000 primiparous singleton pregnancies and 3.9 per 1000 multiparous singleton pregnancies. The effects of maternal age, race, parity, and previous cesarean section were stronger on placenta previa than on placental abruption, and the effects of cigarette smoking, alcohol drinking, and prenatal care were stronger on placental abruption than on placenta previa. A composite outcome of selected medical and pregnancy complications was related with placental abruption but not with placental previa. Placental abruption is more likely to be affected by conditions occurring during pregnancy, and placenta previa is more likely to be affected by conditions existing prior to pregnancy.
KEYWORDS
Placental abruption - placenta previa - risk factors - primiparous women - multiparous women
REFERENCES
-
1 Cunningham GF, MacDonald PC, Gant NF, Leveno KJ, Gilstrap LG Obstetric hemorrhage.
In: Williams' Obstetrics. 19th ed . Norwalk, CT; Appleton and Lange 1993: 819-851 - 2 Rasmussen S, Irgens L M, Bergsjo P, Dalaker K. Perinatal mortality and case fatality after placental abruption in Norway 1967–1991. Acta Obstet Gynecol Scand. 1996; 75 229-234
- 3 Ananth C V, Wilcox A J. Placental abruption and perinatal mortality in the United States. Am J Epidemiol. 2001; 153 332-337
- 4 Ananth C V, Smulian J C, Vintzileos A M. The effect of placenta previa on neonatal mortality: a population-based study in the United States, 1989 through 1997. Am J Obstet Gynecol. 2003; 188 1299-1304
- 5 Tikkanen M, Nuutila M, Hiilesmaa V, Paavonen J, Ylikorkala O. Prepregnancy risk factors for placental abruption. Acta Obstet Gynecol Scand. 2006; 85 40-44
- 6 Iyasu S, Saftlas A K, Rowley D L, Koonim L M, Lawson H W, Atrash H K. The epidemiology of placenta previa in United States, 1979 through 1987. Am J Obstet Gynecol. 1993; 168 1424-1429
- 7 Sheiner E, Shoham-Vardi I, Hallak M, Hershkowitz R, Katz M, Mazor M. Placenta previa: obstetric risk factors and pregnancy outcome. J Matern Fetal Med. 2001; 10 414-419
- 8 Rasmussen S, Albrechtsen S, Dalaker K. Obstetric history and the risk of placenta previa. Acta Obstet Gynecol Scand. 2000; 79 502-507
- 9 Zhang J, Fried D B. Relationship of maternal smoking during pregnancy to placenta previa. Am J Prev Med. 1992; 8 278-282
- 10 Zhang J, Savitz D A. Maternal age and placenta previa: a population-based, case-control study. Am J Obstet Gynecol. 1993; 168 641-645
- 11 Misra D P, Ananth C V. Risk factor profiles of placental abruption in first and second pregnancies: heterogeneous etiologies. J Clin Epidemiol. 1999; 52 453-461
- 12 Ananth C V, Smulian J C, Demissie K, Vintzileos A M, Knuppel R A. Placental abruption among singleton and twin births in the United States: risk factor profiles. Am J Epidemiol. 2001; 153 771-778
- 13 Rasmussen S, Irgens L M, Dalaker K. A history of placental dysfunction and risk of placental abruption. Paediatr Perinat Epidemiol. 1999; 13 9-21
- 14 National Center for Health Statistics .National Center for Health Statistics linked birth/infant death data set: 1989–91 cohort data, 1995–2001 period data. Hyattsville, MD; U.S. Department of Health and Human Services, CDC, National Center for Health Statistics 2003
- 15 Alexander G R, Kotelchuck M. Quantifying the adequacy of prenatal care: a comparison indices. Public Health Rep. 1996; 111 408-418
- 16 Williams M A, Mittendorf R. Increasing maternal age as a determinant of placenta previa. More important than increasing parity?. J Reprod Med. 1993; 38 425-428
- 17 Cieminski A, Dlugolecki F. Relationship between placenta previa and maternal age, parity and prior caesarean deliveries. Ginekol Pol. 2005; 76 284-289 (abstract)
- 18 Meyer M B, Jonas B S, Tonascia J A. Perinatal events associated with maternal smoking during pregnancy. Am J Epidemiol. 1976; 103 464-476
- 19 Naeye R L. Abruptio placentae and placenta previa: frequency, perinatal mortality, and cigarette smoking. Obstet Gynecol. 1980; 55 701-704
- 20 Kramer M D, Taylor V, Hickok D E, Daling J R, Vaughan T L, Hollenbach K A. Maternal smoking and placenta previa. Epidemiology. 1991; 2 221-223
- 21 Williams M A, Mittendorf R, Lieberman E, Monson R R, Schoenbaum S C, Genest D R. Cigarette smoking during pregnancy in relation to placenta previa. Am J Obstet Gynecol. 1991; 165 28-32
- 22 Shen J J, Tymkow C, MacMullen N. Disparities in maternal outcomes among four ethnic populations. Ethn Dis. 2005; 15 492-497
- 23 Healy A J, Malone F D, Sullivan L M et al.. Early access to prenatal care: implications for racial disparity in perinatal mortality. Obstet Gynecol. 2006; 107 625-631
- 24 Rathore S S, McMahon M J. Racial variation in the frequency of intrapartum hemorrhage. Obstet Gynecol. 2001; 97 178-183
- 25 Morgenstern H, Thomas D. Principles of study design in environmental epidemiology. Environ Health Perspect. 1993; 101(suppl 4) 23-38
- 26 Barrett J M, Boehm F H, Killam A P. Induced abortion: a risk factor for placenta previa. Am J Obstet Gynecol. 1981; 141 769-772
- 27 Taylor V M, Kramer M D, Vaughan T L, Peacock S. Placental previa in relation to induced and spontaneous abortion: a population-based study. Obstet Gynecol. 1993; 82 88-91
- 28 Thom D H, Nelson L M, Vaughan T L. Spontaneous abortion and subsequent adverse birth outcomes. Am J Obstet Gynecol. 1992; 166 111-116
- 29 Ananth C V, Smulian J C, Vintzileos A M. The association of placenta previa with history of cesarean delivery and abortion: a metaanalysis. Am J Obstet Gynecol. 1997; 177 1071-1078
- 30 Baumann P, Blackwell S C, Schild C, Berry S M, Friedrich H J. Mathematic modeling to predict abruptio placentae. Am J Obstet Gynecol. 2000; 183 815-822
- 31 Lindqvist P G, Happach C. Risk and risk estimation of placental abruption. Eur J Obstet Gynecol Reprod Biol. 2006; 126 160-164
- 32 Faiz A S, Ananth C V. Etiology and risk factors for placenta previa: an overview and meta-analysis of observational studies. J Matern Fetal Neonatal Med. 2003; 13 175-190
- 33 Budde M P, De Lange T E, Dekker G A, Chan A, Nguyen A M. Risk factors for placental abruption in a socio-economically disadvantaged region. J Matern Fetal Neonatal Med. 2007; 20 687-693
Dr. Qiuying Yang
OMNI Research Group, Ottawa Health Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road
Box 241, Ottawa, Ontario, Canada, K1H 8L6
Email: qyang@ohri.ca