The Effect of Placental Abruption on the Short-Term Outcome of Premature Infants

The purpose of this study was to analyze the effect of abruption on the outcome of preterm infants. Live-born infants of 23 to 32 weeks gestation born at Beaumont Hospital between 1995 and 1999 who suffered abruption constitute the study group. Controls were matched to cases by sex, gestational age, and birth weight. Medical records were retrospectively reviewed for confirmation of abruption, determination of abruption grade, and subsequent neonatal outcome. Univariate analysis of the grade 2 abruption group revealed statistically significant differences in time from diagnosis to delivery (p = 0.04), Apgar scores at 5 minutes (p = 0.04), and acidotic cord blood (p = 0.04) between cases and controls. However, no differences in short-term outcome were appreciated. In addition, no differences in mortality or morbidity were noted between grade 1 abruption case and control infants. We conclude that abruption is not an independent risk factor for poor outcome among infants born between 23 and 32 weeks gestation, but instead induces the preterm delivery that is the main determinant of outcome.

KEYWORDS

Abruption - prematurity - morbidity

REFERENCES

• 1 Creasy R, Resnik R. Maternal Fetal Medicine: Principles and Practice. Philadelphia; W.B. Saunders 1994
• 2 Dunn P. Dr Edward Rigby of Norwich (1747-1821) and antepartum haemorrhage.  Arch Dis Child Fetal Neonatal Ed. 2000;  82 169-170
• 3 Golditch I, Boyce N. Management of abruptio placentae.  JAMA. 1970;  212 288-293
• 4 Hibbard B, Jeffcoate T. Abruptio placentae.  Obstet Gynecol. 1966;  27 155-167
• 5 Ananth C, Wilcox A. Placental abruption and perinatal mortality in the United States.  Am J Epidemiol. 2001;  153 332-337
• 6 Paterson M. The aetiology and outcome of abruptio placentae.  Acta Obstet Gynecol Scand. 1979;  58 31-35
• 7 Ananth C V, Berkowitz G S, Savitz D A, Lapinski R H. Placental abruption and adverse perinatal outcomes.  JAMA. 1999;  282 1646-1651
• 8 Blair R. Abruption of the placenta.  J Obstet Gynaecol Br Commonw. 1973;  80 242-245
• 9 Spinillo A, Fazzi E, Stronati M, Ometto A, Iasci A, Guaschino S. Severity of abruptio placentae and neurodevelopmental outcome in low birth weight infants.  Early Hum Dev. 1993;  35 45-54
• 10 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
• 11 Lunan C. The management of abruptio placentae.  J Obstet Gynaecol Br Commonw. 1973;  80 120-124
• 12 Lowe T, Cunningham G. Placental abruption.  Clin Obstet Gynecol. 1990;  33 406-413
• 13 Hurd W W, Miodovnik M, Hertzberg V, Lavin J P. Selective management of abruptio placentae: a prospective study.  Obstet Gynecol. 1983;  61 467-473
• 14 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
• 15 Page E. Abruptio placentae: dangers of delay in delivery.  Obstet Gynecol. 1954;  3 385-393
• 16 Taeusch. Ballard, Avery. Schaffer & Avery's Disease of the Newborn, 6th ed. Philadelphia; W.B. Saunders 1991