Gestational characteristics and perinatal outcomes in women complicated with placental abruption

Abstract

OBJECTIVE:To evaluate adverse perinatal outcomes among women whose pregnancies were complicated with placental abruption, accompanied by hypertensive disorders of pregnancy. STUDY DESIGN: A retrospective population-based cohort study of pregnancy and perinatal outcomes among women complicated with placental abruption, was conducted. A comparison was made between patients with (study group) and without (comparison group) hypertensive disorders of pregnancy (essential hypertension, gestational hypertension, and preeclampsia toxemia (PET)). Demographic, clinical, and obstetric characteristics were recorded, and pregnancy complications and adverse perinatal outcomes were compared between the groups. Univariate analysis was followed by a multivariate analysis to control for confounders. A p-value of < 0.05 was considered statistically significant. RESULTS: During the study period, of 1,588 pregnancies that were complicated with placental abruption, 218 (13.7%) suffered from hypertensive disorders. A higher rate of antepartum fetal death (APD) was noted among those complicated with placental abruption accompanied by hypertensive disorders. Additionally, preterm birth, nulliparity, lower mean birth weight, and small for gestational age (SGA) neonates were more common in the study group. Finally, women in the study group were more likely to need blood transfusion.In multivariate analyses, hypertensive disorders of pregnancy were found to be independently associated with preterm delivery (OR 1.54, 95% CI 1.14-2.08, p¼0.001) intrauterine growth restriction (OR 3.57, 95% CI 1.42-9.01, p< 0.01) and APD (OR 2.70, 95% CI 1.83-3.99, p< 0.001) in women with placental abruption. CONCLUSION: Among pregnancies complicated with placental abruption hypertensive disorders of pregnancy were significantly associated with a higher incidence of preterm delivery, intrauterine growth restriction, and APD than women with placental abruption without hypertensive disorders. This information contributes to a deeper understanding of the clinical implications of placental abruption in patients with hypertensive disorders of pregnancy.