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Etiologic determinants of abruptio placentae
M S Kramer1, R H Usher, R Pollack
1Department of Epidemiology, McGill University Faculty of Medicine, Montreal, Quebec, Canada.
Obstetrics and Gynecology
|February 1, 1997
Summary
Placental abruption risk factors include fetal growth restriction, prolonged membrane rupture, infections, hypertension, smoking, older maternal age, unmarried status, and male fetal gender. These factors largely impact abruption independently of fetal growth.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Reproductive Health
Background:
- Placental abruption is a significant obstetric complication with multifactorial etiology.
- Understanding the specific contributions of various determinants is crucial for risk assessment and prevention strategies.
Purpose of the Study:
- To quantify the independent roles of sociodemographic, anthropometric, behavioral, and pathological factors in the development of placental abruption.
Main Methods:
- A hospital-based cohort study involving 36,875 nonreferred births.
- Gestational age was determined by menstrual dates confirmed with early ultrasound.
Main Results:
- Significant risk factors identified include severe small for gestational-age (SGA) birth, chorioamnionitis, prolonged rupture of membranes, preeclampsia, pregnancy-induced hypertension, pre-pregnancy hypertension, advanced maternal age (≥35 years), unmarried status, cigarette smoking, and male fetal gender.
- Parity, maternal education, pre-pregnancy weight, and gestational weight gain rate were not significantly associated with abruption.
Conclusions:
- Severe fetal growth restriction, prolonged membrane rupture, chorioamnionitis, hypertension, cigarette smoking, advanced maternal age, unmarried status, and male fetal gender are key etiologic determinants of placental abruption.
- These identified determinants appear to act independently of their impact on fetal growth.