Cande V Ananth1, Darios Getahun, Morgan R Peltier, John C Smulian. 1. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School/Robert Wood Johnson University Hospital, New Brunswick 08901-1977, USA. cande.ananth@umdnj.edu
Abstract
OBJECTIVE: To estimate the magnitude of associations of acute and chronic processes with abruption in preterm and term gestations. METHODS: A retrospective cohort study was performed using data on women that delivered singleton live births and stillbirths at 20 or more weeks of gestation in the United States, 1995-2002 (n = 30,378,902). Rates of 1) acute-inflammation-associated clinical conditions (premature rupture of membranes and intrauterine infection); 2) chronic processes associated with vascular dysfunction or chronic inflammation (chronic and pregnancy-induced hypertension, preexisting or gestational diabetes, small for gestational age, and maternal smoking); and 3) both acute and chronic processes, were examined among women with and without abruption. Rates were examined separately among preterm (< 37 weeks) and term births, with adjustment for confounders. Relative risk (RR) for aforementioned groups in relation to abruption was derived from multivariate logistic regression models after adjusting for potential confounders. RESULTS: At preterm gestation, the rates of acute-inflammation-associated conditions were higher among women with than without abruption (12.0% compared with 10.2%; RR 1.38, 95% confidence interval [CI] 1.34-1.42). At term, acute-inflammation-associated conditions were present in 4.2% and 3.3% of births with and without abruption, respectively (RR 1.39, 95% CI 1.33-1.45). At preterm gestation, the rates of chronic processes were 43.9% and 30.0% among women with and without abruption, respectively (RR 1.87, 95% CI 1.85-1.90). At term, the corresponding rates of chronic processes were 41.0% and 22.7%, respectively (RR 2.37, 95% CI 2.34-2.41). Association between both acute and chronic processes and abruption are similar to those of acute-inflammation-associated conditions. CONCLUSION: Among women with placental abruption, conditions associated with acute inflammation are more prevalent at preterm than term gestations, whereas chronic processes are present throughout gestation. LEVEL OF EVIDENCE: II-2.
OBJECTIVE: To estimate the magnitude of associations of acute and chronic processes with abruption in preterm and term gestations. METHODS: A retrospective cohort study was performed using data on women that delivered singleton live births and stillbirths at 20 or more weeks of gestation in the United States, 1995-2002 (n = 30,378,902). Rates of 1) acute-inflammation-associated clinical conditions (premature rupture of membranes and intrauterine infection); 2) chronic processes associated with vascular dysfunction or chronic inflammation (chronic and pregnancy-induced hypertension, preexisting or gestational diabetes, small for gestational age, and maternal smoking); and 3) both acute and chronic processes, were examined among women with and without abruption. Rates were examined separately among preterm (< 37 weeks) and term births, with adjustment for confounders. Relative risk (RR) for aforementioned groups in relation to abruption was derived from multivariate logistic regression models after adjusting for potential confounders. RESULTS: At preterm gestation, the rates of acute-inflammation-associated conditions were higher among women with than without abruption (12.0% compared with 10.2%; RR 1.38, 95% confidence interval [CI] 1.34-1.42). At term, acute-inflammation-associated conditions were present in 4.2% and 3.3% of births with and without abruption, respectively (RR 1.39, 95% CI 1.33-1.45). At preterm gestation, the rates of chronic processes were 43.9% and 30.0% among women with and without abruption, respectively (RR 1.87, 95% CI 1.85-1.90). At term, the corresponding rates of chronic processes were 41.0% and 22.7%, respectively (RR 2.37, 95% CI 2.34-2.41). Association between both acute and chronic processes and abruption are similar to those of acute-inflammation-associated conditions. CONCLUSION: Among women with placental abruption, conditions associated with acute inflammation are more prevalent at preterm than term gestations, whereas chronic processes are present throughout gestation. LEVEL OF EVIDENCE: II-2.
Authors: Tsegaselassie Workalemahu; Daniel A Enquobahrie; Bizu Gelaye; Sixto E Sanchez; Pedro J Garcia; Fasil Tekola-Ayele; Anjum Hajat; Timothy A Thornton; Cande V Ananth; Michelle A Williams Journal: Placenta Date: 2018-04-16 Impact factor: 3.481
Authors: Cande V Ananth; Marianthi-Anna Kioumourtzoglou; Yongmei Huang; Zev Ross; Alexander M Friedman; Michelle A Williams; Shuang Wang; Murray A Mittleman; Joel Schwartz Journal: Epidemiology Date: 2018-09 Impact factor: 4.822
Authors: M H Schenone; N Schlabritz-Loutsevitch; J Zhang; J E Samson; G Mari; R J Ferry; G B Hubbard; E J Dick Journal: Placenta Date: 2012-01-21 Impact factor: 3.481
Authors: Samantha E Parker; Martha M Werler; Mika Gissler; Minna Tikkanen; Cande V Ananth Journal: Paediatr Perinat Epidemiol Date: 2015-03-11 Impact factor: 3.980
Authors: Cande V Ananth; Morgan R Peltier; Dirk F Moore; Wendy L Kinzler; Daniel Leclerc; Rima R Rozen Journal: Hum Genet Date: 2008-07-16 Impact factor: 4.132