Joo Eun Hui, Kim Nari, Ryu Hyun Mee, Jung Sang Hee, Ahn Eun Hee, Lee Ji Yeon
Department of Obstetrics and Gynecology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
Front Med (Lausanne). 2025 Jul 2;12:1544679. doi: 10.3389/fmed.2025.1544679. eCollection 2025.
This study aimed to investigate the association between clinical characteristics and neonatal developmental delay (DD) in women with placental abruption (PA).
We retrospectively reviewed obstetric characteristics and perinatal outcomes of singleton pregnancies complicated by PA who were healthy before pregnancy between 2010 and 2021. Neuromotor development was evaluated using Bayley Scales of Infant and Toddler Development, Third Edition, and/or Gross Motor Function Measure. Clinical characteristics were compared between offspring with and without developmental delay to identify associated risk factors.
Among 9,374 deliveries, 188 cases (2.0%) were diagnosed with PA, and 33 infants exhibited developmental delay. Maternal demographics, including age, body mass index (BMI), nulliparity, and history of preterm birth, did not differ significantly between groups. Prenatal ultrasound suspected PA in 16.4% of cases in the developmental delay group and 18.2% in the no-delay group. However, a longer interval between diagnosis and delivery [adjusted OR (aOR) = 9.82; 95% CI, 1.25-77.24; = 0.030] and delivery before 32 weeks' gestation (aOR = 19.65; 95% CI, 1.46-264.40; = 0.025) were significantly associated with developmental delay.
Ultrasound findings suggestive of PA were not associated with developmental delay in offspring. However, a prolonged diagnosis-to-delivery interval and extreme prematurity were significant risk factors. These findings underscore the limitations of ultrasound in detecting clinically significant PA and highlight the importance of timely clinical decision-making. Further research is warranted to improve diagnostic strategies for PA.
本研究旨在调查胎盘早剥（PA）女性的临床特征与新生儿发育迟缓（DD）之间的关联。
我们回顾性分析了2010年至2021年间孕前健康的单胎妊娠合并PA的产科特征和围产期结局。使用贝利婴幼儿发展量表第三版和/或粗大运动功能测量来评估神经运动发育。比较有和没有发育迟缓的后代的临床特征，以确定相关危险因素。
在9374例分娩中，188例（2.0%）被诊断为PA，33例婴儿出现发育迟缓。两组之间的产妇人口统计学特征，包括年龄、体重指数（BMI）、初产情况和早产史，差异均无统计学意义。发育迟缓组中16.4%的病例和无发育迟缓组中18.2%的病例在产前超声检查中怀疑有PA。然而，诊断与分娩之间的间隔时间较长[调整后的比值比（aOR）=9.82；95%可信区间，1.25 - 77.24；P = 0.030]以及妊娠32周前分娩（aOR = 19.65；95%可信区间，1.46 - 264.40；P = 0.025）与发育迟缓显著相关。
提示PA的超声检查结果与后代发育迟缓无关。然而，诊断至分娩间隔时间延长和极早产是显著的危险因素。这些发现强调了超声在检测临床上有意义的PA方面的局限性，并突出了及时临床决策的重要性。有必要进一步研究以改进PA的诊断策略。
