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Placental abruption and perinatal death.

N B Kyrklund-Blomberg1, G Gennser, S Cnattingius

  • 1Karolinska Institutet Danderyd Hospital, Division of Obstetrics and Gynaecology, Stockholm, Sweden. Nina.Kyrklund.Blomberg@kids.ki.se

Paediatric and Perinatal Epidemiology
|August 8, 2001
PubMed
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This study identified key risk factors for placental abruption (AP) and perinatal death. Smoking, severe pre-eclampsia, and small-for-gestational-age (SGA) births significantly increased perinatal death risk in AP pregnancies.

Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Reproductive Epidemiology

Background:

  • Risk factors for abruptio placentae (AP) are inconsistently reported.
  • Studies on risk factors for perinatal death in AP pregnancies are limited.
  • A comprehensive understanding of AP and associated mortality risks is crucial for improved maternal and infant outcomes.

Purpose of the Study:

  • To identify and analyze risk factors associated with abruptio placentae (AP).
  • To investigate risk factors for perinatal death in singleton pregnancies complicated by AP.
  • To compare risk factors for perinatal death in pregnancies with and without AP.

Main Methods:

  • Utilized the population-based Swedish Birth Registry (1987-1993) encompassing 795,459 singleton pregnancies.

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  • Employed logistic regression analysis to calculate odds ratios (OR) for AP and perinatal death.
  • Examined a wide range of maternal and pregnancy-related factors as potential risk indicators.

    • Main Results:

    • Identified numerous risk factors for AP, including maternal age, parity, socioeconomic status, smoking, pre-existing conditions (diabetes, hypertension), and pregnancy complications (hypertensive diseases, PROM, preterm birth, SGA).
    • In pregnancies with AP, smoking (OR 1.4-1.7), severe pre-eclampsia (OR 2.0), and SGA (OR 1.9) were significant risk factors for perinatal death.
    • In pregnancies without AP, advanced maternal age (≥35 years), primiparity, infertility, essential hypertension, and pregestational diabetes also increased perinatal death risk.

    Conclusions:

    • Findings suggest that in cases of AP, a generalized placental impairment or defective placentation may lead to fetal demise.
    • Specific risk factors for perinatal death differ between pregnancies with and without AP, highlighting distinct pathophysiological pathways.
    • The study underscores the importance of managing identified risk factors to mitigate adverse perinatal outcomes in AP pregnancies.