title: Placental abruption as a significant risk factor for long-term cardiovascular mortality in a follow-up period of more than a decade.
abstract: BACKGROUND
  To investigate the risk for subsequent cardiovascular events in women having placental abruption during a follow-up period of more than 10 years.
  
  
  METHODS
  A population-based study of the incidence of cardiovascular events in women who had placental abruption with women without placental abruption during 1988-99 and with follow-up until 2010. Associations between placental abruption and maternal long-term cardiovascular morbidity and mortality were investigated. Kaplan-Meier survival curves and multivariable Cox regression were used to estimate cumulative incidence of cardiovascular mortality.
  
  
  RESULTS
  During the study period, there were 47 585 deliveries meeting the inclusion criteria; of these, 653 occurred in patients with placental abruption. No significant association was noted between placental abruption and subsequent long-term hospitalisations because of cardiovascular causes. However, placental abruption was associated with long-term cardiovascular mortality [odds ratio (OR) = 6.6; 95% confidence interval (CI) 2.3, 18.3]. The cardiovascular case fatality rate for the placental abruption group was 13.0% vs. 2.5% in the comparison group (P < 0.001). Patients with a history of placental abruption had a significantly higher risk for cardiovascular mortality during the follow-up period (Log-rank test P = 0.017). Using Cox multivariable regression models, placental abruption remained an independent risk factor for long-term maternal cardiovascular mortality [adjusted hazard ratio (HR) = 4.3; 95% CI 1.1, 18.6).
  
  
  CONCLUSIONS
  Placental abruption is a significant risk factor for long-term cardiovascular mortality in a follow-up period of more than a decade.
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Gali
authors.initials: G
authors.lastname: Pariente
authors.forename: Ilana
authors.initials: I
authors.lastname: Shoham-Vardi
authors.forename: Roy
authors.initials: R
authors.lastname: Kessous
authors.forename: Michael
authors.initials: M
authors.lastname: Sherf
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000037:Abruptio Placentae / Q000401:mortality / Q000503:physiopathology*; D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008969:Molecular Sequence Data; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*; D011256:Pregnancy Outcome; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors
keywords: cardiovascular complications; mortality; placental abruption