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Comparison of neonatal outcome including cerebral palsy between abruptio placentae and placenta previa
Yoshio Matsuda1, Takatsugu Maeda, Satoshi Kouno
1Department of Obstetrics and Gynecology, Kagoshima City Hospital, Kagoshima, Japan. ymatsuda@obgy.twmu.ac.jp
Objective:
Our purpose was to evaluate the neonatal prognosis after abruptio placentae and placenta previa during pre-term gestation.
Study Design:
A case-control study was performed using a logistic regression model. A poor outcome was defined as neonatal death occurring before hospital discharge or a diagnosis of cerebral palsy.
Results:
A poor outcome was more frequent in cases of abruptio placentae (11/42, 26.2%) than in placenta previa (2/72, 2.8%) and pre-term labor (1/120, 0.8%). The difference was mainly due to the incidence of cerebral palsy. A significant association of abruptio placentae (odds ratio (OR) 61.0, 95% confidence interval (CI 3.4-1084), delivery at <31 weeks of gestation (OR 19.0, CI 2.8-128.8), and low Apgar score (<7) at 5min (OR 70.8, CI 16.5-304.9) with increased risk of poor outcome was found in the logistic regression model that controlled for confounding effects. In abruptio placentae, a low Apgar score (<7) at 5min (OR 19.8, CI 2.0-197.8) was associated with increased risk of poor outcome in the logistic regression model.
Conclusion:
From the standpoint of poor perinatal outcome including cerebral palsy, abruptio placentae was the most significant clinical entity in pre-term gestation.