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Vasa previa and extreme prematurity: a population-based study.

Amanda Yeaton-Massey¹, Anna I Girsen², Jonathan A Mayo³

¹Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Stanford University, Stanford, CA, USA. amandaym@gmail.com.

Journal of Perinatology : Official Journal of the California Perinatal Association

|January 30, 2019

Summary

Vasa previa significantly increases the risk of preterm birth, with 63% of affected deliveries occurring before 37 weeks. This highlights the critical need for careful management and counseling for pregnancies with vasa previa.

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Area of Science:

Obstetrics and Gynecology
Perinatal Medicine
Reproductive Health

Background:

Vasa previa is a rare but serious obstetric complication.
Understanding the population-based risks of preterm birth associated with vasa previa is crucial for patient counseling and management.

Purpose of the Study:

To determine the population-based risks of preterm birth in singleton live birth cesarean deliveries associated with vasa previa.
To provide data for counseling patients regarding prematurity risk.

Main Methods:

A population-based retrospective cohort study was conducted using California data from 2007-2012.
Included were 945,950 singleton, live birth cesarean deliveries, with and without vasa previa (gestational ages 24-41 weeks).
Logistic regression was used to estimate odds ratios (ORs) of preterm birth.

Main Results:

Vasa previa occurred in 0.06% (586) of deliveries.
Deliveries with vasa previa had substantially higher odds of extreme preterm birth (OR 4.6) and very preterm birth (OR 16.0) compared to those without.
63% of deliveries with vasa previa occurred before 37 weeks gestation, versus 10% without.

Conclusions:

Most vasa previa cases result in delivery between 32 and 36 weeks gestation.
A clinically significant proportion of vasa previa cases result in delivery before 32 weeks.
These findings are valuable for counseling patients with vasa previa about prematurity risks.