The Risk Factors for Placental Abruption in Preeclamptic Pregnancies: A Retrospective Case-Control Study

Preeclampsia poses a high-risk factor for placental abruption. The precise understanding of the accompanying symptoms and disease phenotype of preeclampsia, in order to promptly identify the occurrence of placental abruption in preeclamptic women, remains unclear.

The obstetric data of preeclamptic women were retrospectively analyzed between January 2016 and June 2023 in our hospital. Based on the presence or absence of placental abruption, they were categorized into two groups: placental abruption group and non-placental abruption group. Logistic regression analysis was employed to identify risk factors for placental abruption in preeclamptic women.

A total of 709 preeclamptic women were enrolled, of whom 39 cases experienced placental abruption. Compared to the non-placental abruption group, the placental abruption group exhibited a younger age, lower BMI at delivery, and higher incidence of HELLP syndrome (p < 0.05). The risk factors for placental abruption in preeclamptic women included systolic blood pressure/10 (aOR 1.293, 95% CI 1.031-1.613), blurred vision (aOR 3.847, 95% CI 1.175-12.600), positive urine protein (aOR 3.081, 95% CI 1.157-8.208), platelet count/10 (aOR 0.923, 95% CI 0.860-0.991), and maternal age (aOR 0.899, 95% CI 0.836-0.966). The placental abruption group had shorter gestational age at delivery and higher rates of cesarean section delivery, fetal growth restriction, and neonatal asphyxia (p < 0.05).

The occurrence of placental abruption in preeclampsia significantly impacts neonatal well-being. Close monitoring of blood pressure, particularly systolic blood pressure, urine protein, platelet counts, and visual acuity is crucial for preeclamptic women to early identify the occurrence of placental abruption.