Sari Räisänen1, Vijaya Kancherla, Michael R Kramer, Mika Gissler, Seppo Heinonen. 1. Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia; the Department of Obstetrics and Gynaecology, Kuopio University Hospital, and the School of Medicine, University of Eastern Finland, Kuopio, and the National Institute for Health and Welfare, Helsinki, Finland; and the Nordic School of Public Health, Gothenburg, Sweden.
Abstract
OBJECTIVE: To evaluate whether there is an association between placenta previa and delivery of a small-for-gestational-age (SGA) newborn and to quantify the contribution of individual risk factors for SGA that are associated with placenta previa stratified by maternal parity. METHODS: A cross-sectional study using the Finnish Medical Birth Register during 2000-2010. All singleton births (N=596,562) were included; major congenital anomalies were excluded. An association between SGA (less than 2 standard deviations below the mean) and placenta previa was modeled by parity-specific unadjusted and adjusted statistical models. RESULTS: Placenta previa complicated 625 of 249,476 singleton births among nulliparous women (2.50/1,000) and 915 of 347,086 singleton births among multiparous women (2.64/1,000). Among nulliparous women, the most common risk factor for placenta previa was in vitro fertilization; placenta previa was not associated with an increased prevalence of SGA controlling for maternal age, smoking, in vitro fertilization, socioeconomic status, and preeclampsia (adjusted odds ratio [OR] 0.81, 95% confidence interval [CI] 0.57-1.17). Among multiparous women, placenta previa was associated with a twofold increased risk of SGA controlling for maternal age, parity, prior preterm birth, prior caesarean delivery, prior SGA newborn, prior preeclampsia, smoking, in vitro fertilization, socioeconomic status, and preeclampsia (adjusted OR 2.08, 95% CI 1.50-2.89). Furthermore, only one-fourth of the association between SGA and placenta previa could be explained by controlling for risk factors clustering with placenta previa among multiparous women. CONCLUSION: Placenta previa is associated with impaired fetal growth in multiparous but not nulliparous women. LEVEL OF EVIDENCE: II.
OBJECTIVE: To evaluate whether there is an association between placenta previa and delivery of a small-for-gestational-age (SGA) newborn and to quantify the contribution of individual risk factors for SGA that are associated with placenta previa stratified by maternal parity. METHODS: A cross-sectional study using the Finnish Medical Birth Register during 2000-2010. All singleton births (N=596,562) were included; major congenital anomalies were excluded. An association between SGA (less than 2 standard deviations below the mean) and placenta previa was modeled by parity-specific unadjusted and adjusted statistical models. RESULTS: Placenta previa complicated 625 of 249,476 singleton births among nulliparous women (2.50/1,000) and 915 of 347,086 singleton births among multiparous women (2.64/1,000). Among nulliparous women, the most common risk factor for placenta previa was in vitro fertilization; placenta previa was not associated with an increased prevalence of SGA controlling for maternal age, smoking, in vitro fertilization, socioeconomic status, and preeclampsia (adjusted odds ratio [OR] 0.81, 95% confidence interval [CI] 0.57-1.17). Among multiparous women, placenta previa was associated with a twofold increased risk of SGA controlling for maternal age, parity, prior preterm birth, prior caesarean delivery, prior SGA newborn, prior preeclampsia, smoking, in vitro fertilization, socioeconomic status, and preeclampsia (adjusted OR 2.08, 95% CI 1.50-2.89). Furthermore, only one-fourth of the association between SGA and placenta previa could be explained by controlling for risk factors clustering with placenta previa among multiparous women. CONCLUSION: Placenta previa is associated with impaired fetal growth in multiparous but not nulliparous women. LEVEL OF EVIDENCE: II.
Authors: Lorie M Harper; Anthony O Odibo; George A Macones; James P Crane; Alison G Cahill Journal: Am J Obstet Gynecol Date: 2010-10 Impact factor: 8.661
Authors: Reut Rotem; Misgav Rottenstreich; Ella Prado; Yael Baumfeld; David Yohay; Gali Pariente; Adi Y Weintraub Journal: Arch Gynecol Obstet Date: 2020-08-03 Impact factor: 2.344
Authors: Hassan S Abduljabbar; Nedaa M Bahkali; Samera F Al-Basri; Estabrq Al Hachim; Ibrahim H Shoudary; Wesam R Dause; Mohammed Y Mira; Mohammed Khojah Journal: Saudi Med J Date: 2016-07 Impact factor: 1.484