Impact of maternal late hospital arrival on adverse outcome of offspring affected by placental abruption: A regional multicenter nested case–control study in Japan

Abstract

Aims To elucidate the influence of the time‐intervals between the onset and arrival (TIME 1), onset and delivery (TIME 2), and the decision to deliver and delivery (TIME 3) on severe adverse outcomes of offspring born to mothers complicated by placental abruption outside the hospital. Methods This is a multicenter nested case–control study about placental abruption at Fukui Prefecture, a regional area in Japan, through 2013 to 2017. Multiple pregnancy, fetal or neonatal congenital abnormality, and unknown detailed information at onset of placental abruption were excluded. A composite of perinatal death and cerebral palsy or death at 18–36 months of corrected age was defined as the adverse outcome. The relationship between time‐intervals and the adverse outcome was analyzed. Results The 45 subjects for analysis were divided into two groups, including a group with and without adverse outcome (poor, n = 8; and good, n = 37). TIME 1 was longer in the poor group (150 vs. 45 min, p < 0.001). A subgroup analysis targeted to 29 cases with preterm birth at the third trimester indicates that TIME 1 and TIME 2 were longer in the poor group (185 vs. 55 min, p = 0.02; and 211 vs. 125 min, p = 0.03), while TIME 3 was shorter in the poor group (21 vs. 53 min, p = 0.01). Conclusions Long time‐intervals between onset and arrival or onset and delivery may be correlated with perinatal death or cerebral palsy in surviving infants affected by placental abruption.

Letter to “Impact of maternal late hospital arrival on adverse outcome of offspring affected by placental abruption: A regional multicenter nested case–control study in Japan”

“…Data sharing not applicable to this article as no datasets were generated or analysed during the current study Shigeki Matsubara 1,2 Hironori Takahashi 1 1…”

“…Dear Editor, Kawamura et al's data 1 are highly significant: in placental abruption, long time-intervals between onset and arrival or onset and delivery were associated with poor fetal/neonatal outcomes; the earlier, the better, similar to many other disorders. The concealed versus nonconcealed type may explain these data.…”

Response to Letter to “Impact of maternal late hospital arrival on adverse outcome of offspring affected by placental abruption: A regional multicenter nested case–control study in Japan”

“…

Dear Editor, We thank Dr. Matsubara and Dr. Takahashi for their interest and insightful comments on our recent research article about the correlation between maternal late hospital arrival and adverse fetal/neonatal outcomes in placental abruption. 1 In our research, the "onset to call time" suggested by Dr. Matsubara et al 2 was not considered because it was not included in the survey. However, we agree that "onset to call time" may become a critical factor in determining the fetal/neonatal outcomes in placental abruption.

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