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The association between placenta abruption and congenital anomalies: A systematic review and meta-analysis
Amir Mohammad Salehi1,2, Ensiyeh Jenabi3, Sima Kamkari4
1Fetal & Pediatric Cardiovascular Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Placental abruption (PA) significantly increases the risk of congenital abnormalities (CAs) in infants. Further research is needed to understand this association, and monitoring for CAs is recommended in pregnancies with PA.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Health
- Reproductive Medicine
Background:
- Congenital abnormalities (CAs) are a major global cause of child mortality and disability.
- Identifying risk factors for CAs is crucial for prevention and intervention strategies.
- Placental abruption (PA) is a pregnancy complication with potential implications for fetal development.
Purpose of the Study:
- To systematically review and analyze the existing evidence on the association between placental abruption (PA) and congenital abnormalities (CAs).
- To quantify the risk of CAs in infants exposed to PA during pregnancy.
Main Methods:
- A systematic literature search was conducted across major databases (PubMed, Web of Science, Scopus, Science Direct) up to July 2025.
- A random-effects model was employed for meta-analysis, with heterogeneity assessed using chi-square and I² statistics.
- Publication bias was evaluated using Egger's and Begg's regression tests, and study quality was assessed using the modified Newcastle-Ottawa Scale (NOS).
Main Results:
- Six studies were included, revealing a significant association between PA and an increased risk of CAs (OR = 2.83; 95% CI: 1.88 to 3.79).
- Substantial heterogeneity was noted (I² = 91.9%, P < 0.001), but subgroup analysis showed significant associations in both case-control (OR = 1.95) and cohort studies (OR = 3.28).
- Homogeneity was observed within the case-control study subgroup (I² = 0.0%, P = 0.523).
Conclusions:
- This systematic review confirms a significant positive association between placental abruption and the occurrence of congenital abnormalities.
- While causality cannot be definitively established, the findings suggest a heightened risk for fetuses experiencing PA.
- Close monitoring for congenital abnormalities is recommended in fetuses of mothers diagnosed with placental abruption.
Abstract:
BackgroundCongenital abnormalities (CAs) are a significant cause of death and disability among children worldwide. Identifying risk factors can help reduce the incidence and mortality associated with CAs. This study aimed to explore the relationship between placental abruption (PA) and congenital abnormalities (CAs).MethodsA systematic search was conducted in PubMed (Medline), Web of Science, Scopus, and Science Direct, up to July 10, 2025. The analysis utilized a random-effects model. To evaluate heterogeneity among the studies, we applied the chi-square test (χ2) and the I2 statistic. Additionally, regression tests, including Egger's and Begg's tests, were carried out to assess publication bias. The quality of observational studies was evaluated using the modified Newcastle-Ottawa Scale (NOS). A p-value of less than 0.05 was considered statistically significant, and the analysis was performed using Stata software, version 13.ResultsIn total, six studies met the inclusion criteria and were included in this systematic review. A significant association was found, with PA increasing the risk of CAs (OR = 2.83; 95% CI: 1.88 to 3.79). Substantial heterogeneity was observed among the studies (I2 = 91.9%, P < 0.001). After subgrouping, a significant association between PA and the risk of CAs was observed in both case-control studies (OR = 1.95, 95% CI: 1.51 to 2.38; I2 = 0.0%, P = 0.523) and cohort studies (OR = 3.28, 95% CI: 1.68 to 4.88; I2 = 95.1%, P < 0.001). Notably, homogeneity was found among the case-control studies.ConclusionOur study demonstrates a significant positive association between PA and CAs, but causality cannot be inferred. Thus, it is suggested to monitor for CAs in the fetus of mothers with PA.
