Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Ave North, Guangzhou, 510515, China.
Department of Obstetrics and Gynecology, Guangzhou Medical Centre for Critical Pregnant Women, Key Laboratory for Major Obstetric Diseases of Guangdong Province, Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Liwan District, Guangzhou, 510150, China.
BMC Pregnancy Childbirth. 2020 Apr 15;20(1):212. doi: 10.1186/s12884-020-02890-3.
To determine the effects of previous placenta previa on the maternal and neonatal outcomes of the next pregnancy.
This 10-year retrospective cohort study was conducted in the Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, between January 2009 and 2018. We retrospectively analyzed the effects of a previous singleton pregnancy in women with and without placenta previa on the outcomes of the subsequent pregnancy. To control for confounders, we used multiple logistic regression models.
A total of 57,251 women with singleton pregnancies gave birth during the 10-year study period. Among them, 6070 women had two consecutive births. For the first pregnancy, 1603 women delivered by cesarean delivery and 4467 by vaginal delivery. Among women with a history of cesarean delivery, placenta previa was an independent risk factor for hemorrhage (adjusted odds ratio [aOR]: 2.25, 95% confidence interval [CI]: 1.1-4.62), placenta accreta spectrum (PAS) disorders (aOR: 4.11, 95% CI: 1.68-10.06), and placenta previa (aOR: 6.24, 95% CI: 2.85-13.67) during the subsequent pregnancy. Puerperal infection, blood transfusion, and perinatal outcomes did not significantly differ between women with a history of placenta previa and women without this history. Among women with a history of vaginal delivery, placenta previa increased the risk of PAS disorders (aOR: 5.71, 95% CI: 1.81-18.03) and placenta previa (aOR: 4.14, 95% CI: 1.07-16.04) during the subsequent pregnancy. There was no significant difference between the two groups in terms of hemorrhage, blood transfusion, puerperal infection, and perinatal outcomes.
Women with a history of placenta previa are at risk for adverse outcomes such as postpartum hemorrhage, PAS disorders, and placenta previa in the subsequent pregnancy.
为了确定前置胎盘对下次妊娠母婴结局的影响。
这是一项在 2009 年 1 月至 2018 年期间于广州医科大学附属第三医院妇产科进行的为期 10 年的回顾性队列研究。我们回顾性分析了有和没有前置胎盘的单胎妊娠对后续妊娠结局的影响。为了控制混杂因素，我们使用了多因素逻辑回归模型。
在 10 年的研究期间，共有 57251 名单胎妊娠的妇女分娩。其中，6070 名妇女连续两次分娩。第一次妊娠中，1603 例行剖宫产，4467 例行阴道分娩。在有剖宫产史的妇女中，前置胎盘是出血（调整优势比[aOR]：2.25，95%置信区间[CI]：1.1-4.62）、胎盘植入谱系（PAS）疾病（aOR：4.11，95% CI：1.68-10.06）和后续妊娠中前置胎盘（aOR：6.24，95% CI：2.85-13.67）的独立危险因素。有前置胎盘史和无前置胎盘史的妇女在产褥期感染、输血和围产儿结局方面无显著差异。在有阴道分娩史的妇女中，前置胎盘增加了 PAS 疾病（aOR：5.71，95% CI：1.81-18.03）和后续妊娠中前置胎盘（aOR：4.14，95% CI：1.07-16.04）的风险。两组在出血、输血、产褥期感染和围产儿结局方面无显著差异。
有前置胎盘史的妇女在后续妊娠中发生产后出血、PAS 疾病和前置胎盘等不良结局的风险增加。
