Zhang Li, Yang Hong, Sun Yong, Liu Shasha
Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, NO.745 Wuluo Road, Hongshan District, Wuhan City, 430070, Hubei Province, P.R. China.
BMC Pregnancy Childbirth. 2025 May 28;25(1):620. doi: 10.1186/s12884-025-07718-6.
Placental abruption (PA), a severe obstetric complication, defined as the partial or complete detachment of a normally situated placenta from the uterine wall before birth, after 20 weeks of gestation, is associated with significant maternal and neonatal morbidity and mortality. Despite its clinical importance, the pathogenesis of PA remains unclear, and there is limited research specifically comparing outcomes in term and preterm pregnancies with PA. This study aimed to evaluate maternal and neonatal outcomes in pregnancies complicated by PA on basis of the timing of PA onset, with a focus on differences between term and preterm deliveries.
This retrospective study included a total of 757 singleton pregnant women with confirmed PA from a tertiary obstetrics hospital care center between June 2020 to March 2024, who were classified into the preterm group (n = 300) and the full-term group (n = 457) based on their gestational age of PA onset. The baseline characteristics, maternal and newborn outcomes were collected from electronic health records in hospital information system, and further analyzed between two groups. The adjusted odds ratios (aORs) for the risk of adverse pregnancy outcomes on basis of term or preterm delivery in women with PA were analyzed by using multivariate logistic regression models.
Women with preterm delivery had about 3 times greater risk for uterus-placenta apoplexy (aOR: 2.93, 95% CI 1.33-6.47, P = 0.01), 3 times greater risk for fetal growth restriction (aOR: 3.47, 95% CI 1.45-8.30, P = 0.01), 3 times greater risk for adult intensive care unit (ICU, aOR: 3.28, 95% CI 1.27-8.46, P = 0.01), and less chances to use oxytocin (aOR: 0.21, 95% CI 0.13-0.32, P < 0.01). Premature newborns had less chances to use forceps (aOR: 0.09, 95% CI 0.01-0.76, P = 0.02), but about 10 times greater risk for stillbirth (aOR: 9.38, 95% CI 1.10 - 79.68, P < 0.01).
Preterm pregnancies with PA are associated with higher risks of severe maternal complications and adverse neonatal outcomes, underscoring the need for enhanced clinical surveillance and timely intervention. Future research should focus on elucidating underlying mechanisms and developing effective prevention strategies, while long-term follow-up is essential to assess the health outcomes of affected infants.
Not applicable.
胎盘早剥（PA）是一种严重的产科并发症，定义为妊娠20周后、分娩前正常位置的胎盘部分或完全从子宫壁剥离，与孕产妇和新生儿的高发病率和死亡率相关。尽管其具有临床重要性，但PA的发病机制仍不清楚，专门比较足月和早产PA妊娠结局的研究有限。本研究旨在根据PA发病时间评估PA妊娠的孕产妇和新生儿结局，重点关注足月和早产分娩之间的差异。
这项回顾性研究纳入了2020年6月至2024年3月期间来自一家三级产科医院护理中心的757名单胎确诊PA孕妇，根据PA发病时的孕周分为早产组（n = 300）和足月组（n = 457）。从医院信息系统的电子健康记录中收集基线特征、孕产妇和新生儿结局，并在两组之间进行进一步分析。使用多因素逻辑回归模型分析PA女性足月或早产分娩时不良妊娠结局风险的调整比值比（aOR）。
早产女性发生子宫胎盘卒中的风险约高3倍（aOR：2.93，95%CI 1.3–6.47，P = 0.01），胎儿生长受限的风险高3倍（aOR：3.47，95%CI 1.45–8.30，P = 0.01），入住成人重症监护病房（ICU）的风险高3倍（aOR：3.28，95%CI 1.27–8.46，P = 0.01），使用缩宫素的机会较少（aOR：0.21，95%CI 0.13–0.32，P < 0.01）。早产新生儿使用产钳的机会较少（aOR：0.09，95%CI 0.01–0.76，P = 0.02），但死产风险约高10倍（aOR：9.38，95%CI 1.10–79.68，P < 0.01）。
PA早产妊娠与严重孕产妇并发症和不良新生儿结局的较高风险相关，强调需要加强临床监测和及时干预。未来的研究应侧重于阐明潜在机制和制定有效的预防策略，而长期随访对于评估受影响婴儿的健康结局至关重要。
不适用。
需注意，原文中“95%CI 1.3–6.47”疑似有误，应为“95%CI 1.33–6.47”，译文已按正确内容翻译。
