Viana Pinto Pedro, Kawka-Paciorkowska Katarzyna, Morlando Maddalena, Huras Hubert, Kołak Magdalena, Bertholdt Charline, Jaworowski Andrzej, Braun Thorsten, Fox Karin A, Morel Olivier, Paping Alexander, Stefanovic Vedran, Mhallem Mina, Van Beekhuizen Heleen J
Gynecology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal.
Department of Perinatology, Poznan University of Medical Sciences, Poznan, Poland.
Acta Obstet Gynecol Scand. 2025 Apr;104 Suppl 1(Suppl 1):38-44. doi: 10.1111/aogs.14919. Epub 2024 Jul 14.
Placenta accreta spectrum disorders (PAS) lead to major complications in pregnancy. While the maternal morbidity associated with PAS is well known, there is less information regarding neonatal morbidity in this setting. The aim of this study is to describe the neonatal outcomes (fetal malformations, neonatal morbidity, twin births, stillbirth, and neonatal death), using an international multicenter database of PAS cases.
This was a prospective, multicenter cohort study based on prospectively collected cases, using the international multicenter database of the International Society for PAS, carried out between January 2020 and June 2022 by 23 centers with experience in PAS care. All PAS cases were included, regardless of whether singleton or multiple pregnancies and were managed in each center according to their own protocols. Data were collected via chart review. Local Ethical Committee approval and Data Use Agreements were obtained according to local policies.
There were 315 pregnancies eligible for inclusion, with 12 twin pregnancies, comprising 329 fetuses/newborns; 2 cases were excluded due to inconsistency of data regarding fetal abnormalities. For the calculation of neonatal morbidity and mortality, all elective pregnancy terminations were excluded, hence 311 pregnancies with 323 newborns were analyzed. In our cohort, 3 neonates (0.93%) were stillborn; of the 320 newborns delivered, there were 10 cases (3.13%) of neonatal death. The prevalence of major congenital malformations was 4.64% (15/323 newborns), most commonly, cardiovascular, central nervous system, and gastrointestinal tract malformations. The overall prevalence of major neonatal morbidity in pregnancies complicated by PAS was 47/311 (15.1%). There were no stillbirths, neonatal deaths, or fetal malformations in reported twin gestations.
Although some outcomes may be too rare to detect within our cohort and data should be interpreted with caution, our observational data supports reassuring neonatal outcomes for women with PAS.
胎盘植入谱系疾病（PAS）会导致妊娠期间出现严重并发症。虽然与PAS相关的孕产妇发病率众所周知，但关于这一情况下新生儿发病率的信息较少。本研究的目的是利用一个国际多中心PAS病例数据库来描述新生儿结局（胎儿畸形、新生儿发病率、双胎分娩、死产和新生儿死亡）。
这是一项前瞻性多中心队列研究，基于前瞻性收集的病例，使用国际胎盘植入协会的国际多中心数据库，由23个有PAS护理经验的中心在2020年1月至2022年6月期间开展。所有PAS病例均纳入，无论单胎或多胎妊娠，并在每个中心根据各自的方案进行管理。数据通过病历审查收集。根据当地政策获得了当地伦理委员会的批准和数据使用协议。
有315例妊娠符合纳入标准，其中12例为双胎妊娠，共329例胎儿/新生儿；2例因胎儿异常数据不一致而被排除。为计算新生儿发病率和死亡率，所有选择性终止妊娠均被排除，因此分析了311例妊娠及323例新生儿。在我们的队列中，3例新生儿（0.93%）为死产；在320例分娩的新生儿中，有10例（3.13%）新生儿死亡。主要先天性畸形的患病率为4.64%（15/323例新生儿），最常见的是心血管、中枢神经系统和胃肠道畸形。PAS合并妊娠中主要新生儿发病率的总体患病率为（47/311，15.1%）。报告的双胎妊娠中没有死产、新生儿死亡或胎儿畸形。
尽管某些结局可能在我们的队列中过于罕见而无法检测到，且数据应谨慎解读，但我们的观察性数据表明PAS女性的新生儿结局令人安心。
