title: Placental abruption: critical analysis of risk factors and perinatal outcomes.
abstract: OBJECTIVE
  To investigate risk factors and pregnancy outcome of patients with placental abruption.
  
  
  METHODS
  A population-based study comparing all pregnancies of women with and without placental abruption was conducted. Stratified analysis using multiple logistic regression models was performed to control for confounders.
  
  
  RESULTS
  During the study period there were 185,476 deliveries, of which 0.7% (1365) occurred in patients with placental abruption. The incidence of placental abruption increased between the years 1998 to 2006 from 0.6 to 0.8%. Placental abruption was more common at earlier gestational age. The following conditions were significantly associated with placental abruption, using a multivariable analysis with backward elimination: hypertensive disorders, prior cesarean section, maternal age, and gestational age. Placental abruption was significantly associated with adverse perinatal outcomes such as Apgar scores < 7 at 1 and 5 min and perinatal mortality. Patients with placental abruption were more likely to have cesarean deliveries, as well as cesarean hysterectomy.Using another multivariate analysis, with perinatal mortality as the outcome variable, controlling for gestational age, hypertensive disorders, etc., placental abruption was noted as an independent risk factor for perinatal mortality.
  
  
  CONCLUSIONS
  Placental abruption is an independent risk factor for perinatal mortality. Since the incidence of placental abruption has increased during the last decade, risk factors should be carefully evaluated in an attempt to improve surveillance and outcome.
authors.affiliation: Faculty of Health Sciences, Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Gali
authors.initials: G
authors.lastname: Pariente
authors.forename: Arnon
authors.initials: A
authors.lastname: Wiznitzer
authors.forename: Ruslan
authors.initials: R
authors.lastname: Sergienko
authors.forename: Moshe
authors.initials: M
authors.lastname: Mazor
authors.forename: Gershon
authors.initials: G
authors.lastname: Holcberg
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000037:Abruptio Placentae / Q000453:epidemiology*; D000328:Adult; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008423:Maternal Age; D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D055815:Young Adult