Abstract
Objectives
To identify risk factors for placental abruption and to evaluate associations between
adverse perinatal outcomes and placental abruption stratified by parity among women
with singleton births from 1991 to 2010 in Finland.
Study design
A retrospective population-based case–control study of singleton births in Finland
from 1991 to 2010 (n = 1,162,126 from the Finnish Medical Birth Register). We modelled the group-specific
risk factors for placental abruption in unadjusted and adjusted models.
Results
In total 3.5 and 3.7 per 1000 nulliparous and multiparous women, respectively, were
affected by placental abruption. The recurrence rate was 8.6 per 1000 births. The
adjusted risk for placental abruption increased in pregnancies characterised by advanced
maternal age, low birth weight, smoking, major congenital anomaly, preeclampsia and
male foetal sex in both parity groups. In vitro fertilisation increased the risk only
in nulliparae whereas anaemia, a prior caesarean section and the lowest socioeconomic
status increased the risk in multiparae. Births affected by placental abruption were
associated with an increased admission for neonatal intensive care, preterm birth,
low birth weight (<2500 g), small for gestational age infants, low Apgar scores, and low newborn umbilical
vein pH (<7.15). Placental abruption resulted in increased risks of stillbirth and
early neonatal death in both parity groups.
Conclusions
The burden of placental abruption is equal in nulliparae and multiparae, but risk
factors vary substantially. Social disparity only affects the incidence of placental
abruption among multiparous women, indicating that factors related to lifestyle and
health behaviour have different effects on the parity groups.
Keywords
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Article info
Publication history
Published online: September 26, 2013
Accepted:
September 12,
2013
Received in revised form:
August 17,
2013
Received:
June 16,
2013
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
