Schur Erga, Baumfeld Yael, Rotem Reut, Weintraub Adi Y, Pariente Gali
Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 151, 84101, Beer-Sheva, Israel.
Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, affiliated with the Hebrew University Medical School of Jerusalem, Jerusalem, Israel.
Arch Gynecol Obstet. 2022 Nov;306(5):1547-1554. doi: 10.1007/s00404-022-06638-6. Epub 2022 Jun 9.
To evaluate changes in the independent contribution of different risk factors for placental abruption over time.
In this retrospective nested case-control study, trends of change in ORs for known risk factors for placental abruption occurring in three consecutive 8-year intervals were compared. A univariate assessment of factors associated with placental abruption and two multivariable logistic regression models were constructed to identify independent risk factors for placental abruption. Trends of change in the incidence and specific contribution of various risk factors were compared along the study time-period.
During the study period, 295,946 pregnancies met the inclusion criteria; of these, 2170 (0.73%) were complicated with placental abruption. Using logistic regression models, previous cesarean delivery, in vitro fertilization (IVF) pregnancy, hypertensive disorders, polyhydramnios, and inadequate prenatal care were recognized as independent risk factors for placental abruption. While the relative contribution of IVF pregnancy and polyhydramnios to the overall risk for abruption decreased over the course of the study, previous cesarean delivery became a stronger contributor for placental abruption.
In our study, a change over time in the specific contribution of different risk factors for placental abruption has been demonstrated.
评估不同胎盘早剥风险因素的独立作用随时间的变化。
在这项回顾性巢式病例对照研究中，比较了连续三个8年期间胎盘早剥已知风险因素的比值比（OR）变化趋势。对与胎盘早剥相关的因素进行单因素评估，并构建两个多变量逻辑回归模型以确定胎盘早剥的独立风险因素。比较了研究期间各风险因素发生率和具体作用的变化趋势。
在研究期间，295,946例妊娠符合纳入标准；其中，2170例（0.73%）并发胎盘早剥。使用逻辑回归模型，既往剖宫产、体外受精（IVF）妊娠、高血压疾病、羊水过多和产前检查不足被确认为胎盘早剥的独立风险因素。在研究过程中，IVF妊娠和羊水过多对胎盘早剥总体风险的相对作用降低，而既往剖宫产成为胎盘早剥的更强危险因素。
在我们的研究中，已证明胎盘早剥不同风险因素的具体作用随时间发生了变化。
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