Comparison of Maternal Risk Factors between Placental Abruption and Placenta Previa

Qiuying Yang; Shi Wu Wen; Karen Phillips; Lawrence Oppenheimer; Douglas Black; Mark C. Walker

doi:10.1055/s-0028-1103156

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Am J Perinatol 2009; 26(4): 279-286
DOI: 10.1055/s-0028-1103156

Comparison of Maternal Risk Factors between Placental Abruption and Placenta Previa

Qiuying Yang¹ ^, ² , Shi Wu Wen¹ ^, ² ^, ³ , Karen Phillips⁴ , Lawrence Oppenheimer² , Douglas Black² , Mark C. Walker¹ ^, ²

¹OMNI Research Group, Clinical Epidemiology Program, Ottawa Health Research Institute, University of Ottawa, Ontario, Canada
²Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ontario, Canada
³Department of Epidemiology and Community Medicine, University of Ottawa, Ontario, Canada
⁴Baccalaureate Program in Health Sciences, Faculty of Health Sciences, University of Ottawa, Ontario, Canada

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Publication Date:
19 November 2008 (online)

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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

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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