General Obstetrics and Gynecology: Obstetrics
Risk factors of abruptio placentae among Peruvian women

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Objective

We examined the relation of maternal sociodemographic, medical, and behavioral characteristics with risk of abruptio placentae in Peruvian women.

Study design

This case-control study included 255 abruptio placentae cases and 258 pregnant controls. Multivariable logistic regression models were fit to calculate odds ratios (OR) and 95% CIs adjusted for putative abruptio placentae risk factors.

Results

History of delivering a stillborn infant (OR 10.0; 95%CI 4.0-25.2), pregnancy complicated by preeclampsia/eclampsia (OR 3.7; 95%CI 2.2-6.3); and a low rate of pregnancy weight gain (<0.15 kg/wk) (OR 2.5; 95%CI 1.3-4.7), were associated with significantly increased risk of abruptio placentae. Advanced maternal age, low educational attainment, male infant gender, cigarette smoking, and grand multiparty were not risk factors of abruptio placentae in this population.

Conclusion

At present, the constellation of abruptio placentae risk factors do not provide clinically meaningful opportunities for identifying high-risk patients.

Section snippets

Study population and abruptio placentae case and control definition

This case-control study, the Peruvian Abruptio Placentae Epidemiology (PAPE) Study, was conducted at the Hospital Nacional Dos de Mayo, Instituto Especializado Materno Perinatal, and Hospital Madre-Niño San Bartolomé in Lima, Peru, from August 2002 through May 2004.

Abruptio placentae cases were identified by daily monitoring of all new admissions to antepartum, emergency room, and labor and delivery wards of participating hospitals. Study subjects were recruited during their hospital stay.

Results

The prevalence of abruptio placentae in the study setting was 0.7% or 289/41,175. Abruptio placentae cases were more than twice as likely to deliver preterm as compared with controls (Table I). We did not have information concerning the occurrence of premature rupture of membranes. Stillbirths occurred more frequently among cases than controls (259 vs 12 per 1000 deliveries, P < .001).

In bivariate analyses summarized in Table II, we observed evidence of a modest and statistically nonsignificant

Comment

The prevalence of abruptio placentae in the study setting was 0.7%. This frequency is similar to estimates reported in other populations.8 Risk factors for abruptio placentae in this urban South American population of largely low-income women included a previous history of delivering a stillborn infant, having the pregnancy complicated by preeclampsia/eclampsia, and a low rate of weight gain during pregnancy. These risk factors are consistent with reports from other study populations.3, 7, 8, 12

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