title: Placenta accreta and maternal morbidity in the Republic of Ireland, 2005-2010.
abstract: OBJECTIVE
  To describe the nationwide prevalence of placenta accreta and to quantify its impact on maternal morbidity.
  
  
  METHODS
  Using discharge data for public hospitals in Ireland, years 2005-2010, deliveries with placenta accreta were identified using ICD-10-AM code for morbidly adherent placenta and compared with deliveries without the condition. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated using logistic regression.
  
  
  RESULTS
  Placenta accreta prevalence increased 34% from 2005 to 2010 (7.9/10 000 deliveries versus 10.6/10 000 deliveries). This condition was associated with a substantial increased risk of hemorrhage (aOR: 16.6, 95% CI: 13.4-20.5), hysterectomy (aOR: 950.6, 95% CI: 632.9-1427.9), procedures to reduce uterine blood flow (aOR: 72.4, 95% CI: 35.1-149.4), transfusion (aOR: 41.8, 95% CI: 33.4-52.2), anemia (aOR 15.1, 95% CI: 10.8-21.0), abdominal organ injury (aOR: 8.2, 95% CI: 5.2-13.1), bladder surgery (aOR: 38.5, 95% CI: 21.8-68.1), mechanical ventilation (aOR: 63.2, 95% CI: 28.4-140.6), intensive care unit admission (aOR: 41.3, 95% CI: 30.0-56.9), and co-existing placenta previa (aOR: 23.2, 95% CI: 16.8-31.8) as well as increased risk of cesarean section, longer hospitalization and stillbirth.
  
  
  CONCLUSIONS
  To our knowledge, this is the first study to use a comparison group of deliveries without placenta accreta and quantitatively illustrate with odds ratios the profound adverse health effects of this condition on the mother.
authors: Department of Epidemiology, School of Public Health, University of Washington , Seattle, WA , USA .
authors: Kristen
authors: K
authors: Upson
authors: Robert M
authors: RM
authors: Silver
authors: Richard
authors: R
authors: Greene
authors: Jennifer
authors: J
authors: Lutomski
authors: Victoria L
authors: VL
authors: Holt
mesh_terms: D000007:Abdominal Injuries / Q000453:epidemiology; D000740:Anemia / Q000453:epidemiology; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D053715:Cystotomy / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007494:Ireland / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D010921:Placenta Accreta / Q000453:epidemiology*; D010923:Placenta Previa / Q000453:epidemiology; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D015995:Prevalence; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D050497:Stillbirth / Q000453:epidemiology; D001743:Urinary Bladder / Q000601:surgery; D055357:Uterine Artery Embolization / Q000706:statistics & numerical data