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Cardiovascular Disease in Singleton Offspring Born of Pregnancies Complicated by Placental Abruption: A

Cande V Ananth1,2,3,4,5, Emily B Rosenfeld1,6, Rachel Lee1

  • 1Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences Rutgers Robert Wood Johnson Medical School New Brunswick NJ.

Journal of the American Heart Association
|March 25, 2026
PubMed

Insights

Children born after placental abruption face higher risks of death and cardiovascular disease (CVD). These risks, linked to placental dysfunction, emerge early and continue throughout life.

Area of Science:

  • Perinatal Medicine
  • Cardiovascular Epidemiology
  • Pediatric Health

Background:

  • Placental abruption is a known risk factor for maternal cardiovascular disease (CVD).
  • Offspring risks for mortality and CVD following placental abruption are not well-established.
  • This study investigates the association between placental abruption and offspring mortality and CVD events.

Purpose of the Study:

  • To examine the association between placental abruption during pregnancy and the risk of all-cause mortality in offspring.
  • To assess the risk of fatal and nonfatal cardiovascular disease (CVD) events in offspring exposed to placental abruption.
  • To determine if these risks persist throughout the offspring's life course.

Main Methods:

  • Retrospective cohort study utilizing the PACER cohort (New Jersey, 1993-2020).
  • Cox proportional hazards models were used to estimate risks associated with abruption.
  • Sibling-pair analyses were conducted to control for familial confounding.

Main Results:

  • Offspring born after placental abruption had significantly higher rates of CVD mortality (aHR, 4.64) and nonfatal CVD events (aHR, 2.86).
  • Elevated risks were observed even in the first year of life and persisted over a median follow-up of 14.5 years.
  • Sibling-pair analyses confirmed the associations, indicating a link beyond shared familial factors.

Conclusions:

  • Pregnancies complicated by placental abruption increase the offspring's long-term burden of mortality and cardiovascular disease.
  • The heightened CVD risk associated with abruption is apparent from infancy and continues across the lifespan.
  • Placental dysfunction in abruption may contribute to the offspring's future cardiovascular risk profile.
Abstract

Keywords:
cardiovascular diseasemultistate modelsoffspringplacental abruptionsibling designunmeasured confounding bias

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