Department of Obstetrics and Gynecology and
Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Pediatrics. 2018 Aug;142(2). doi: 10.1542/peds.2017-3915. Epub 2018 Jul 12.
Placental abruption causes asphyxia and leads to high perinatal mortality. Our objective was to study the overall mortality and causes of death among children born after placental abruption.
Data on children born from singleton pregnancies complicated by placental abruption between 1987 and 2005 were collected from the Finnish Medical Birth Register, the Hospital Discharge Register, and the Cause-of-Death Register. A reference group consisted of children born from pregnancies without placental abruption. After excluding stillbirths, the final study sample comprised 3888 children born after placental abruption (index children) and 12 530 referent children. The main outcome measure was overall mortality.
By the end of 2013, there were 280 deaths among the index children and 107 deaths among the referent children. Compared with the referent children, the overall mortality among the index children was significantly increased (hazard ratio: 8.70; 95% confidence interval 6.96-10.90). During the neonatal period (0-27 days) the mortality was nearly 15-fold (14.8; 10.9-20.0), birth-related asphyxia being the leading cause of death (108; 34-341). The mortality remained high during days 28 to 365 (10.3; 4.83-21.8) and beyond 365 days (1.70; 1.03-2.79). Furthermore, the overall mortality was increased among the index children born at 32 to 36 + 6 gestational weeks (2.77; 1.54-4.98) and at ≥37 weeks (4.98; 3.54-6.99) and among children with a birth weight of 2500 g or more (5.94; 4.33-8.14).
The impact of abruption on offspring mortality extends far beyond the perinatal period. This is mainly due to birth-related asphyxia and prematurity-related consequences.
胎盘早剥可导致胎儿窒息，进而导致围产儿死亡率升高。我们的目的是研究胎盘早剥后分娩的患儿的总体死亡率和死因。
从 1987 年至 2005 年芬兰的医疗出生登记处、住院记录和死因登记处收集了因胎盘早剥而导致的单胎妊娠患儿的数据。参考组由无胎盘早剥的妊娠患儿组成。在排除死产儿后，最终的研究样本包括 3888 例胎盘早剥后分娩的患儿（指数患儿）和 12530 例对照患儿。主要结局指标为总体死亡率。
截至 2013 年底，指数患儿中有 280 例死亡，对照患儿中有 107 例死亡。与对照患儿相比，指数患儿的总体死亡率显著升高（危险比：8.70；95%置信区间：6.96-10.90）。在新生儿期（0-27 天），死亡率几乎增加了 15 倍（14.8；10.9-20.0），与出生相关的窒息是主要死因（108；34-341）。在 28 至 365 天（10.3；4.83-21.8）和 365 天以上（1.70；1.03-2.79）死亡率仍然较高。此外，在妊娠 32 周至 36+6 周（2.77；1.54-4.98）和≥37 周（4.98；3.54-6.99）分娩的指数患儿以及出生体重≥2500 g 的患儿中，总体死亡率也升高（5.94；4.33-8.14）。
胎盘早剥对后代死亡率的影响远远超出围生期。这主要是由于与出生相关的窒息和与早产相关的后果所致。
