Wu Serena, Kocherginsky Masha, Hibbard Judith U
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Chicago, Ill, USA.
Am J Obstet Gynecol. 2005 May;192(5):1458-61. doi: 10.1016/j.ajog.2004.12.074.
This study was undertaken to determine whether the rate of abnormal placentation is increasing in conjunction with the cesarean rate and to evaluate incidence, risk factors, and outcomes.
Cases from 1982-2002 were identified by histopathologic or strong clinical criteria. Risk factors were assessed in a matched case-control study, and analyzed using conditional logistic regression models.
There were 64,359 deliveries, with cesarean rates increasing from 12.5% (1982) to 23.5% (2002). The overall incidence of placenta accreta was 1 in 533. Significant risk factors for placenta accreta in our final analysis included advancing maternal age (odds ratio [OR] 1.13, 95% CI 1.089-1.194, P < .0001), 2 or more cesarean deliveries (OR 8.6, 95% CI 3.536-21.078, P < .0001), and previa (OR 51.4, 95% CI: 10.646-248.390, P < .0001).
The rate of placenta accreta increased in conjunction with cesarean deliveries; the most important risk factors were previous cesarean delivery, previa, and advanced maternal age.
本研究旨在确定异常胎盘植入率是否随剖宫产率上升而增加，并评估其发生率、危险因素及结局。
通过组织病理学或强有力的临床标准确定1982 - 2002年的病例。在一项匹配病例对照研究中评估危险因素，并使用条件逻辑回归模型进行分析。
共有64359例分娩，剖宫产率从1982年的12.5%升至2002年的23.5%。胎盘植入的总体发生率为1/533。在我们的最终分析中，胎盘植入的显著危险因素包括产妇年龄增加（比值比[OR]1.13，95%可信区间[CI]1.089 - 1.194，P <.0001）、2次或更多次剖宫产（OR 8.6，95% CI 3.536 - 21.078，P <.0001）以及前置胎盘（OR 51.4，95% CI：10.646 - 248.390，P <.0001）。
胎盘植入率随剖宫产分娩增加；最重要的危险因素是既往剖宫产、前置胎盘和产妇年龄增加。
