Cardiovascular disease and mortality following placental abruption

We investigate the relationship between placental abruption and cardiovascular disease (CVD) events using a population-based, retrospective cohort study of individuals who delivered a singleton birth between 1993 and 2020 in New Jersey, USA. We fit multistate weighted Cox models to estimate the risks of non-fatal CVD hospitalization, all-cause mortality, and non-fatal CVD hospitalization to all-cause mortality. We examine these associations in two non-overlapping cohorts of individuals with their first delivery only (parity 1) and those with the first two consecutive deliveries (parity 1-2). Associations were corrected for unmeasured confounding bias. Of 2 874 671 deliveries, 1.0% (n = 28 913) had an abruption. The median follow-up was 16 years (range, 0-28 years). Compared to no abruption, placental abruption among first deliveries was associated with adjusted hazard ratio (HR) of 1.27 (95% confidence interval [CI], 1.11-1.46) for the transition from delivery to non-fatal CVD hospitalization; HR, 1.77 (95% CI, 1.28-2.44) for all-cause mortality; and HR, 1.52 (95% CI, 0.98-2.37) for non-fatal CVD hospitalization to all-cause mortality. The corresponding HRs for recurrent placental abruption (parity 1-2 cohort) were stronger, although less precise. Corrections for unmeasured confounding slightly attenuated these risks. These findings underscore the importance of placental abruption as a potential risk factor for maternal CVD risks.