Outcome of pregnancies subsequent to placental abruption: a risk assessment.
OBJECTIVE
To assess the risk of small for gestational age (SGA), preterm birth, pregnancy induced hypertension (PIH), and perinatal death in the pregnancy immediate subsequent to a placental abruption (PA) in the same mother.


METHODS
A cohort study based on the Medical Birth Registry of Norway.


RESULTS
Odds ratios of SGA in subsequent PA- and non-PA deliveries were 2.8 (absolute risk = 18.5%) and 2.0 (13.9%), respectively, compared with non-PA deliveries without a history of previous PA among siblings (7.5%) after exclusion of cases with SGA in the immediate previous birth. After exclusion of cases with spontaneous preterm birth in the immediate previous delivery, odds ratios of spontaneous preterm birth in subsequent PA- and non-PA deliveries were 17.0 (36.3%) and 2.1 (6.6%), compared with non-PA deliveries without a history of previous PA among siblings (3.2%). After exclusion of cases with PIH in the immediate previous pregnancy, odds ratios of PIH in subsequent PA- and non-PA pregnancies were 2.9 (6.3%) and 1.6 (3.4%), compared with non-PA deliveries without a history of previous PA among siblings (2.3%). After adjustment for demographic variables and obstetrical complications, the increased risks persisted.


CONCLUSIONS
A pregnancy following a PA must be considered a high risk pregnancy, not only in terms of excess risk of recurrence, but also due to excess risk of SGA, preterm birth, and PIH irrespective of recurrence of PA. Consequently, all pregnancies following a pregnancy with PA should be offered close antenatal surveillance and care.
Rasmussen
S
S
The Medical Birth Registry of Norway, Locus of Registry-based Epidemiology, University of Bergen, Department of Obstetrics and Gynecology, University Hospital of Bergen.
Irgens
L M
LM
Dalaker
K
K
D000037:Abruptio Placentae / Q000209:etiology*; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D012008:Recurrence; D018570:Risk Assessment