Download PDF
Am J Perinatol 2010; 27(3): 235-240
DOI: 10.1055/s-0029-1239490
© Thieme Medical Publishers

Increased Risk of Placental Abruption in Underweight Women

Aaron B. Deutsch1 , O'Neill Lynch2 , Amina P. Alio3 , Hamisu M. Salihu1 , 2 , William N. Spellacy1
  • 1Department of Obstetrics and Gynecology, University of South Florida, Tampa, Florida
  • 2The Chiles Center for Healthy Mothers and Babies, University of South Florida, Tampa, Florida
  • 3Department of Community and Family Health, University of South Florida, Tampa, Florida
Further Information

Publication History

Publication Date:
26 September 2009 (online)

Also available at
    Permissions and Reprints

ABSTRACT

We sought to determine if there is a relationship between prepregnancy underweight status and placental abruption. We utilized the Missouri maternally linked cohort data files covering the period 1989 through 1997. We estimated the association between prepregnancy underweight subtypes and placental abruption using adjusted odds ratios. Subanalyses were performed to determine whether the amount of weight gained during pregnancy could modify the association. A total of 439,235 singleton pregnancies with 3696 abruptions were analyzed. Underweight mothers had a 40% greater likelihood for placental abruption (odds ratio 1.4; 95% confidence interval 1.3 to 1.5). The risk increased with ascending severity of underweight status (p for trend <0.01). There was a trend toward decreased risk for placental abruption among underweight women with adequate weight gain in pregnancy. Prepregnancy maternal underweight status is associated with placental abruption. This risk may be reduced with adequate weight gain during pregnancy.

KEYWORDS

Nutrition - placental abruption - pregnancy - underweight

REFERENCES

  • 1 Oyelese Y, Ananth C V. Placental abruption.  Obstet Gynecol. 2006;  108 1005-1016
    CrossrefPubMedGoogle Scholar
  • 2 Ananth C V, Oyelese Y, Yeo L, Pradhan A, Vintzileos A M. Placental abruption in the United States, 1979 through 2001: temporal trends and potential determinants.  Am J Obstet Gynecol. 2005;  192 191-198
    CrossrefPubMedGoogle Scholar
  • 3 Brame R G, Harbert Jr G M, McGaughey Jr H S, Thornton Jr W N. Maternal risk in abruption.  Obstet Gynecol. 1968;  31 224-227
    CrossrefPubMedGoogle Scholar
  • 4 Naeye R L, Harkness W L, Utts J. Abruptio placentae and perinatal death: a prospective study.  Am J Obstet Gynecol. 1977;  128 740-746
    PubMedGoogle Scholar
  • 5 Ananth C V, Berkowitz G S, Savitz D A, Lapinski R H. Placental abruption and adverse perinatal outcomes.  JAMA. 1999;  282 1646-1651
    CrossrefPubMedGoogle Scholar
  • 6 Abdella T N, Sibai B M, Hays Jr J M, Anderson G D. Relationship of hypertensive disease to abruptio placentae.  Obstet Gynecol. 1984;  63 365-370
    PubMedGoogle Scholar
  • 7 Krohn M, Voigt L, McKnight B, Daling J R, Starzyk P, Benedetti T J. Correlates of placental abruption.  Br J Obstet Gynaecol. 1987;  94 333-340
    PubMedGoogle Scholar
  • 8 Kåregård M, Gennser G. Incidence and recurrence rate of abruptio placentae in Sweden.  Obstet Gynecol. 1986;  67 523-528
    PubMedGoogle Scholar
  • 9 Ananth C V, Smulian J C, Vintzileos A M. Incidence of placental abruption in relation to cigarette smoking and hypertensive disorders during pregnancy: a meta-analysis of observational studies.  Obstet Gynecol. 1999;  93 622-628
    CrossrefPubMedGoogle Scholar
  • 10 Hoskins I A, Friedman D M, Frieden F J, Ordorica S A, Young B K. Relationship between antepartum cocaine abuse, abnormal umbilical artery Doppler velocimetry, and placental abruption.  Obstet Gynecol. 1991;  78 279-282
    PubMedGoogle Scholar
  • 11 Kramer M S, Usher R H, Pollack R, Boyd M, Usher S. Etiologic determinants of abruptio placentae.  Obstet Gynecol. 1997;  89 221-226
    CrossrefPubMedGoogle Scholar
  • 12 Sahu M T, Agarwal A, Das V, Pandey A. Impact of maternal body mass index on obstetric outcome.  J Obstet Gynaecol Res. 2007;  33 655-659
    CrossrefPubMedGoogle Scholar
  • 13 Ehrenberg H M, Dierker L, Milluzzi C, Mercer B M. Low maternal weight, failure to thrive in pregnancy, and adverse pregnancy outcomes.  Am J Obstet Gynecol. 2003;  189 1726-1730
    CrossrefPubMedGoogle Scholar
  • 14 Dietz P M, Callaghan W M, Cogswell M E, Morrow B, Ferre C, Schieve L A. Combined effects of prepregnancy body mass index and weight gain during pregnancy on the risk of preterm delivery.  Epidemiology. 2006;  17 170-177
    CrossrefPubMedGoogle Scholar
  • 15 Schieve L A, Cogswell M E, Scanlon K S The NMIHS Collaborative Study Group et al. Prepregnancy body mass index and pregnancy weight gain: associations with preterm delivery.  Obstet Gynecol. 2000;  96 194-200
    CrossrefPubMedGoogle Scholar
  • 16 Williams M A, Lieberman E, Mittendorf R, Monson R R, Schoenbaum S C. Risk factors for abruptio placentae.  Am J Epidemiol. 1991;  134 965-972
    PubMedGoogle Scholar
  • 17 Hung T H, Hsieh C C, Hsu J J, Lo L M, Chiu T H, Hsieh T T. Risk factors for placental abruption in an Asian population.  Reprod Sci. 2007;  14 59-65
    CrossrefPubMedGoogle Scholar
  • 18 Piper J M, Mitchel Jr E F, Snowden M, Hall C, Adams M, Taylor P. Validation of 1989 Tennessee birth certificates using maternal and newborn hospital records.  Am J Epidemiol. 1993;  137 758-768
    PubMedGoogle Scholar
  • 19 Herman A A, McCarthy B J, Bakewell J M et al.. Data linkage methods used in maternally-linked birth and infant death surveillance data sets from the United States (Georgia, Missouri, Utah and Washington State), Israel, Norway, Scotland and Western Australia.  Paediatr Perinat Epidemiol. 1997;  11(suppl 1) 5-22
    CrossrefPubMedGoogle Scholar
  • 20 WHO .Physical status: the use and interpretation of anthropometry. Report of a WHO Expert committee WHO technical report series 854. Geneva; World Health Organization 1995
    Google Scholar
  • 21 Herman A A, Yu K F. Adolescent age at first pregnancy and subsequent obesity.  Paediatr Perinat Epidemiol. 1997;  11(suppl 1) 130-141
    CrossrefPubMedGoogle Scholar
  • 22 WHO Expert Consultation . Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies.  Lancet. 2004;  363 157-163
    CrossrefPubMedGoogle Scholar
  • 23 Dietz P M, Callaghan W M, Cogswell M E, Morrow B, Ferre C, Schieve L A. Combined effects of prepregnancy body mass index and weight gain during pregnancy on the risk of preterm delivery.  Epidemiology. 2006;  17 170-177
    CrossrefPubMedGoogle Scholar
  • 24 Wingate M S, Alexander G R, Buekens P, Vahratian A. Comparison of gestational age classifications: date of last menstrual period vs. clinical estimate.  Ann Epidemiol. 2007;  17 425-430
    CrossrefPubMedGoogle Scholar
  • 25 Taffel S, Johnson D, Heuser R. A method of imputing length of gestation on birth certificates.  Vital Health Stat 2. 1982;  93 1-11
    PubMedGoogle Scholar
  • 26 Alexander G R, Kotelchuck M. Quantifying the adequacy of prenatal care: a comparison of indices.  Public Health Rep. 1996;  111 408-418 discussion 419
    PubMedGoogle Scholar
  • 27 Alexander G R, Cornely D A. Prenatal care utilization: its measurement and relationship to pregnancy outcome.  Am J Prev Med. 1987;  3 243-253
    PubMedGoogle Scholar
  • 28 Alexander G R, Kogan M, Martin J, Papiernik E. What are the fetal growth patterns of singletons, twins, and triplets in the United States?.  Clin Obstet Gynecol. 1998;  41 114-125
    PubMedGoogle Scholar
  • 29 Weiss J L, Malone F D, Emig D FASTER Research Consortium et al. Obesity, obstetric complications and cesarean delivery rate—a population-based screening study.  Am J Obstet Gynecol. 2004;  190 1091-1097
    CrossrefPubMedGoogle Scholar
  • 30 Helgstrand S, Andersen A M. Maternal underweight and the risk of spontaneous abortion.  Acta Obstet Gynecol Scand. 2005;  84 1197-1201
    CrossrefPubMedGoogle Scholar
  • 31 Micali N, Simonoff E, Treasure J. Risk of major adverse perinatal outcomes in women with eating disorders.  Br J Psychiatry. 2007;  190 255-259
    CrossrefPubMedGoogle Scholar
  • 32 Pathak P, Kapil U. Role of trace elements zinc, copper and magnesium during pregnancy and its outcome.  Indian J Pediatr. 2004;  71 1003-1005
    CrossrefPubMedGoogle Scholar
  • 33 Fawzi W W, Msamanga G I, Urassa W et al.. Vitamins and perinatal outcomes among HIV-negative women in Tanzania.  N Engl J Med. 2007;  356 1423-1431
    CrossrefPubMedGoogle Scholar
  • 34 Sharma S C, Bonnar J, Dóstalóva L. Comparison of blood levels of vitamin A, beta-carotene and vitamin E in abruptio placentae with normal pregnancy.  Int J Vitam Nutr Res. 1986;  56 3-9
    PubMedGoogle Scholar
  • 35 Rasmussen S, Irgens L M, Dalaker K. A history of placental dysfunction and risk of placental abruption.  Paediatr Perinat Epidemiol. 1999;  13 9-21
    CrossrefPubMedGoogle Scholar
  • 36 Dommisse J, Tiltman A J. Placental bed biopsies in placental abruption.  Br J Obstet Gynaecol. 1992;  99 651-654
    PubMedGoogle Scholar
  • 37 Ananth C V, Oyelese Y, Prasad V, Getahun D, Smulian J C. Evidence of placental abruption as a chronic process: associations with vaginal bleeding early in pregnancy and placental lesions.  Eur J Obstet Gynecol Reprod Biol. 2006;  128) 15-21
    PubMedGoogle Scholar

Aaron B DeutschM.D. 

3144 Bayshore Oaks Dr., Tampa

FL 33611

Email: adeutsch@hsc.usf.edu