识别既往无胎盘早剥史的孕妇再次发生胎盘早剥的危险因素。

Identifying risk factors for placental abruption in subsequent pregnancy without a history of placental abruption.

机构信息

Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

出版信息

Int J Gynaecol Obstet. 2023 May;161(2):406-411. doi: 10.1002/ijgo.14446. Epub 2022 Sep 21.

DOI:10.1002/ijgo.14446

PMID:36083780

Abstract

OBJECTIVE

To identify first pregnancy risk factors for placental abruption in subsequent pregnancy.

METHODS

In a population-based nested case-control study, cases were defined as women with placental abruption in their second pregnancy, and controls as women without abruption. A total of 43 328 women were included in the study, 0.4% (n = 186) of second pregnancies had placental abruption. Multivariable logistic models were used to study the association between first pregnancy complications and placental abruption in subsequent pregnancy.

RESULTS

Having either small for gestational age, preterm delivery, pre-eclampsia or cesarean delivery during first pregnancy were independently associated with increased risk for placental abruption, and the risk was higher with any additional complication (age adjusted odds ratio [aOR] 2.00, 95% confidence interval [CI] 1.46-2.74; aOR 3.61, 95% CI 2.23-5.86; and aOR 3.86, 95% CI 1.56-9.56, for one, two, and three or more complications, respectively).

CONCLUSION

First pregnancy may serve as a window of opportunity to identify women at risk for future placental abruption.

摘要

目的

确定首次妊娠的胎盘早剥风险因素，以便预测后续妊娠中发生胎盘早剥的风险。

方法

在一项基于人群的巢式病例对照研究中，将第二次妊娠发生胎盘早剥的女性定义为病例，而未发生胎盘早剥的女性则定义为对照。共有 43328 名女性纳入本研究，其中 0.4%（n=186）的第二次妊娠发生了胎盘早剥。采用多变量逻辑模型研究了首次妊娠并发症与后续妊娠中胎盘早剥之间的关联。

结果

首次妊娠时发生胎儿生长受限、早产、子痫前期或剖宫产与胎盘早剥风险增加相关，且伴随的并发症越多，风险越高（经年龄调整的比值比[aOR]分别为 2.00、95%置信区间[CI]为 1.46-2.74；aOR 分别为 3.61、95%CI 为 2.23-5.86；aOR 分别为 3.86、95%CI 为 1.56-9.56）。