Abstract
Objective
Preeclampsia, small for gestational age (SGA) and placental abruption – conditions
that constitute the syndrome of “ischemic placental disease” (IPD) – may portend different
clinical manifestations of a common underlying pathophysiology. We examined if (i)
preeclampsia, SGA and abruption share similar risk profiles; and (ii) if there are
any differences in these profiles between patients with IPD that delivered at term
and preterm gestations.
Study design
We utilized data from the US Collaborative Perinatal Project, a multicenter, prospective
cohort study (1959–1966), restricted to women that delivered singleton births at ≥20
weeks (n = 47,495.) We compared risk factors between women with and without IPD as well as preeclampsia,
SGA and abruption.
Results
A strong overlap in risk factors for all 3 conditions was evident. Socio-economic
class, income, age, parity, education, race, BMI, marital status, and history of preterm
birth were different between preterm and term gestations in women with IPD. Although
rates of preeclampsia only, SGA only and preeclampsia with SGA were similar between
term and preterm birth, rates of other conditions were higher at preterm gestations,
with abruption being the driving condition behind these associations.
Conclusions
The similar risk profiles for preeclampsia, SGA, and abruption provide compelling
evidence to suggest that these conditions may share common pathophysiological mechanisms—ischemic
placental disease. Greater homogeneity in risk profiles within preterm than term births
suggests that IPD may be a syndrome that has strong underpinnings at preterm gestations.
Key words
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Article info
Publication history
Published online: July 29, 2011
Accepted:
July 11,
2011
Received in revised form:
June 13,
2011
Received:
April 13,
2011
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
