Neonatal Respiratory Outcomes in Placenta Previa with Histopathologically Confirmed Placenta Accreta Spectrum

Area of Science:

• Obstetrics and Gynecology
• Neonatology
• Perinatology

Background:

• Placenta accreta spectrum (PAS) complicating placenta praevia is linked to severe maternal complications.
• Neonatal respiratory burden in PAS pregnancies may be underestimated.
• This study investigates neonatal respiratory outcomes in relation to PAS.

Purpose of the Study:

• To compare neonatal respiratory outcomes in pregnancies with and without placenta accreta spectrum (PAS).
• To assess the impact of gestational age on respiratory outcomes in neonates from PAS pregnancies.
• To provide evidence for improved obstetric-neonatal planning in suspected PAS cases.

Main Methods:

• Retrospective single-centre cohort study of 82 pregnancies.
• Classification of pregnancies into PAS (n=37) and non-PAS (n=45) based on placental histopathology.
• Analysis of respiratory endpoints including resuscitation, non-invasive support, and oxygen requirements, adjusted for gestational age.

Main Results:

• PAS pregnancies showed significantly higher rates of respiratory resuscitation at birth (72.2% vs. 43.2%) and need for supplemental oxygen (80.6% vs. 47.7%).
• Adjusted analysis confirmed PAS association with increased respiratory resuscitation (aOR 3.34) and oxygen requirement (aOR 4.60).
• Association with non-invasive respiratory support was not statistically significant after adjustment (aOR 4.46, p=0.064).

Conclusions:

• Histopathologically confirmed PAS is associated with elevated neonatal respiratory support needs, independent of gestational age.
• Findings underscore the necessity for proactive obstetric and neonatal care coordination when PAS is suspected.
• Early recognition and management planning are crucial for improving neonatal outcomes in PAS pregnancies.