PDF herunterladen
Am J Perinatol 2009; 26(4): 279-286
DOI: 10.1055/s-0028-1103156
© Thieme Medical Publishers

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
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
19. November 2008 (online)

Auch verfügbar auf
    Lizenzen und Reprints

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
    Suche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 3 Ananth C V, Wilcox A J. Placental abruption and perinatal mortality in the United States.  Am J Epidemiol. 2001;  153 332-337
    CrossrefPubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 8 Rasmussen S, Albrechtsen S, Dalaker K. Obstetric history and the risk of placenta previa.  Acta Obstet Gynecol Scand. 2000;  79 502-507
    CrossrefPubMedSuche in Google Scholar
  • 9 Zhang J, Fried D B. Relationship of maternal smoking during pregnancy to placenta previa.  Am J Prev Med. 1992;  8 278-282
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 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
    Suche in Google Scholar
  • 15 Alexander G R, Kotelchuck M. Quantifying the adequacy of prenatal care: a comparison indices.  Public Health Rep. 1996;  111 408-418
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 17 Cieminski A, Dlugolecki F. Relationship between placenta previa and maternal age, parity and prior caesarean deliveries.  Ginekol Pol. 2005;  76 284-289 (abstract)
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 19 Naeye R L. Abruptio placentae and placenta previa: frequency, perinatal mortality, and cigarette smoking.  Obstet Gynecol. 1980;  55 701-704
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 22 Shen J J, Tymkow C, MacMullen N. Disparities in maternal outcomes among four ethnic populations.  Ethn Dis. 2005;  15 492-497
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 24 Rathore S S, McMahon M J. Racial variation in the frequency of intrapartum hemorrhage.  Obstet Gynecol. 2001;  97 178-183
    CrossrefPubMedSuche in Google Scholar
  • 25 Morgenstern H, Thomas D. Principles of study design in environmental epidemiology.  Environ Health Perspect. 1993;  101(suppl 4) 23-38
    CrossrefPubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 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
    PubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 31 Lindqvist P G, Happach C. Risk and risk estimation of placental abruption.  Eur J Obstet Gynecol Reprod Biol. 2006;  126 160-164
    CrossrefPubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar
  • 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
    CrossrefPubMedSuche in Google Scholar

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