Placental Abruption and Cardiovascular Event Risk (PACER): Design, data linkage, and preliminary findings

Area of Science:

• Obstetrics and Gynecology
• Cardiovascular Health
• Epidemiology

Background:

• Obstetrical complications, including placental abruption, contribute to chronic disease burden in mothers and offspring.
• Placental abruption is a critical condition with poorly understood long-term cardiovascular health implications.

Purpose of the Study:

• To describe the design and data linkage algorithms for the Placental Abruption and Cardiovascular Event Risk (PACER) cohort.
• To establish a population-based cohort for studying the lifelong cardiovascular risks associated with placental abruption.

Main Methods:

• Retrospective, population-based, birth cohort study of deliveries in New Jersey (1993-2020).
• Linked vital records of fetal deaths and live births to subsequent hospitalizations for mothers and newborns using probabilistic record-matching.
• Achieved high linkage rates for maternal (92.4%) and offspring (70.3%) hospitalizations.

Main Results:

• The study identified 1,877,824 birthing persons and 3,093,241 deliveries, with a 1.1% prevalence of placental abruption.
• Median follow-up was 15.4 years for mothers and 14.4 years for offspring.
• Methods for handling missing data and selection bias due to unlinked records are planned.

Conclusions:

• Pregnancy provides a critical window for studying life course chronic diseases.
• Understanding the etiology of placental abruption may offer insights into cardiovascular disease development.
• The PACER cohort offers a unique opportunity to investigate abruption's role in predisposing individuals to cardiovascular complications.