Placental Abruption: Temporal Trends, Risk Factors, and Associated Adverse Maternal Outcomes

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Epidemiology

Background:

• Placental abruption is a significant obstetric complication.
• Understanding its trends and associated factors is crucial for maternal care.
• Previous studies have highlighted various risk factors, but long-term trends require ongoing evaluation.

Purpose of the Study:

• To evaluate temporal trends in placental abruption during delivery hospitalizations from 2000 to 2020.
• To identify associated risk factors, including demographic and clinical variables.
• To assess the association between placental abruption and adverse maternal outcomes.

Main Methods:

• A serial cross-sectional study using the National Inpatient Sample (2000-2020).
• Joinpoint regression analyzed temporal trends in abruption incidence.
• Adjusted logistic regression models assessed associations with risk factors and adverse outcomes.

Main Results:

• Placental abruption incidence increased from 1.2% to 1.6% (AAPC: 1.6%) over the study period.
• Associated factors included multiple gestations, hypertensive diagnoses, diabetes, asthma, and Medicaid insurance.
• Abruption significantly increased odds of transfusion (OR=6.86), severe maternal morbidity (OR=4.05), postpartum hemorrhage (OR=1.76), and critical care procedures (OR=4.76).

Conclusions:

• Placental abruption risk has increased over the past two decades.
• The condition is associated with a wide range of severe maternal complications.
• Given its rising incidence, placental abruption will likely remain a key contributor to adverse obstetric outcomes.