Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Goethe University Frankfurt, University Hospital, Theodor-Stern Kai 7, 60590, Frankfurt, Germany.
Sci Rep. 2024 Feb 29;14(1):4999. doi: 10.1038/s41598-024-55531-6.
Placenta accreta spectrum (PAS) has become a significant life-threatening issue due to its increased incidence and associated morbidity and mortality. Pregnancy is often associated with states of anaemia, and severe maternal haemorrhage represents a major risk factor for red blood cell (RBC) transfusion. The present study retrospectively analyzed the prevalence of anaemia, transfusion requirements and outcome in women with PAS. Using data from the German Statistical Office pregnant patients with deliveries hospitalized between January 2012 and December 2021 were included. Primary outcome was the prevalence of anemia and administration of RBCs. Secondary outcome were complications in women with PAS who received RBC transfusion. In total 6,493,606 pregnant women were analyzed, of which 38,060 (0.59%) were diagnosed with PAS. The rate of anaemia during pregnancy (60.36 vs. 23.25%; p < 0.0001), postpartum haemorrhage (47.08 vs. 4.41%; p < 0.0001) and RBC transfusion rate (14.68% vs. 0.72%; p < 0.0001) were higher in women with PAS compared to women without PAS. Women with PAS who had bleeding and transfusion experienced significantly more peripartum complications than those who did not. A multiple logistic regression revealed that the probability for RBC transfusion in all pregnant women was positively associated with anaemia (OR 21.96 (95% CI 21.36-22.58)). In women with PAS, RBC transfusion was positively associated with the presence of renal failure (OR 11.27 (95% CI 9.35-13.57)) and congestive heart failure (OR 6.02 (95% CI (5.2-7.07)). Early anaemia management prior to delivery as well as blood conservation strategies are crucial in women diagnosed with PAS.
胎盘植入谱系疾病（PAS）的发病率不断增加，相关发病率和死亡率也随之升高，因此成为了一个严重的威胁生命的问题。妊娠常伴有贫血状态，而严重的产妇出血是红细胞（RBC）输血的主要危险因素。本研究回顾性分析了 PAS 患者的贫血患病率、输血需求和结局。研究使用了德国统计局的数据，纳入了 2012 年 1 月至 2021 年 12 月期间住院分娩的孕妇。主要结局是贫血和 RBC 输血的发生率。次要结局是接受 RBC 输血的 PAS 患者的并发症。共分析了 6493606 名孕妇，其中 38060 名（0.59%）诊断为 PAS。PAS 患者妊娠期间贫血发生率（60.36% vs. 23.25%；p<0.0001）、产后出血发生率（47.08% vs. 4.41%；p<0.0001）和 RBC 输血率（14.68% vs. 0.72%；p<0.0001）均高于无 PAS 患者。有出血和输血史的 PAS 患者在围产期并发症方面显著多于无出血和输血史的患者。多因素逻辑回归显示，所有孕妇 RBC 输血的概率与贫血呈正相关（OR 21.96（95%CI 21.36-22.58））。在 PAS 患者中，RBC 输血与肾衰竭的发生呈正相关（OR 11.27（95%CI 9.35-13.57））和充血性心力衰竭（OR 6.02（95%CI 5.2-7.07））。分娩前早期贫血管理和血液保护策略对 PAS 患者至关重要。
