Iyasu S, Saftlas A K, Rowley D L, Koonin L M, Lawson H W, Atrash H K
Division of Reproductive Health, Centers for Disease Control, Atlanta, Georgia.
Am J Obstet Gynecol. 1993 May;168(5):1424-9. doi: 10.1016/s0002-9378(11)90776-5.
Placenta previa can cause serious, occasionally fatal complications for fetuses and mothers; however, data on its national incidence and sociodemographic risk factors have not been available.
We analyzed data from the National Hospital Discharge Survey for the years 1979 through 1987 and from the Retrospective Maternal Mortality Study (1979 through 1986).
We found that placenta previa complicated 4.8 per 1000 deliveries annually and was fatal in 0.03% of cases. Incidence rates remained stable among white women but increased among black and other minority women (p < 0.1). In addition, the risk of placenta previa was higher for black and other minority women than for white women (rate ratio 1.3, 95% confidence interval 1.0 to 1.7), and it was higher for women > or = 35 years old than for women <20 years old (rate ratio 4.7, 95% confidence interval 3.3 to 7.0). Women with placenta previa were at an increased risk of abruptio placentae (rate ratio 13.8), cesarean delivery (rate ratio 3.9), fetal malpresentation (rate ratio 2.8), and postpartum hemorrhage (rate ratio 1.7).
Our findings support the need for improved prenatal and intrapartum care to reduce the serious complications and deaths associated with placenta previa.
前置胎盘可导致严重的、偶尔致命的母婴并发症；然而，关于其全国发病率及社会人口统计学风险因素的数据尚无可用资料。
我们分析了1979年至1987年全国医院出院调查数据以及回顾性孕产妇死亡研究（1979年至1986年）的数据。
我们发现前置胎盘每年每1000例分娩中有4.8例并发，0.03%的病例致死。白人女性的发病率保持稳定，而黑人及其他少数族裔女性的发病率有所上升（p<0.1）。此外，黑人及其他少数族裔女性前置胎盘的风险高于白人女性（率比1.3，95%置信区间1.0至1.7），35岁及以上女性的风险高于20岁以下女性（率比4.7，95%置信区间3.3至7.0）。前置胎盘女性发生胎盘早剥（率比13.8）、剖宫产（率比3.9）、胎位异常（率比2.8）及产后出血（率比1.7）的风险增加。
我们的研究结果支持需要改善产前和产时护理，以减少与前置胎盘相关的严重并发症和死亡。
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