Maternal and neonatal outcomes of abnormal placentation: a case-control study

There is limited information on neonatal outcomes in complicated pregnancies with abnormal placentation. The aim of this study was to assess the neonatal outcomes of abnormal placentation.

In this case-control study, known cases of abnormal placentation between the years 2010 and 2017 were extracted. The case group consisted of pregnant women with abnormal placentation (172 cases), while controls were selected from repeated cesarean section cases with normal placentation (341 people).

In the case group, 145 cases (84.3%) had placenta accreta, 12 cases (7.07%) had placenta increta and five cases (8.7%) had placenta percreta. Characteristics significantly more common in the case group included lower mean gestational age and average neonatal weight (p < .001), low birth weight (LBW) and small for gestational age (SGA) (p < .001), admission to the NICU (p < .001), higher average number of hospitalization days in the NICU (p < .05), lower average 5-minute Apgar scores (p < .001), neonatal seizure (p = .004), cranial hemorrhage (p = .037), anemia (p = .002) and thrombocytosis (p = .029). The occurrence of abnormal placentation was associated with some underlying maternal characteristics such as high maternal age (p = .34), lower maternal weight (p = .044), multiparity (p = .11), history of previous abortion (p = .036), and history of cesarean (p = .001). The prevalence of placenta previa was significantly higher in the case group (p < .001).

The presence of placenta previa has a close relationship with abnormal placentation and is considered to be a potential risk factor for LBW, SGA, lower 5 minutes Apgar scores, first-day seizure, cranial hemorrhage, the necessity for NICU admission and occurrence of anemia and thrombocytosis in neonates.