title: Risk factors for perinatal mortality in patients admitted to the hospital with the diagnosis of placental abruption.
abstract: OBJECTIVE
  Placental abruption is a clinical term used when premature separation of the placenta from the uterine wall occurs prior to delivery of the fetus. Hypertension, substance abuse, smoking, intrauterine infection and recent trauma are risk factors for placental abruption. In this study, we sought for clinical factors that increase the risk for perinatal mortality in patients admitted to the hospital with the clinical diagnosis of placental abruption.
  
  
  METHODS
  We identified all placental abruption cases managed over the past 6 years at our Center. Those with singleton pregnancies and a diagnosis of abruption based on strict clinical criteria were selected. Eleven clinical variables that had potential for increasing the risk for perinatal mortality were selected, logistic regression analysis was used to identify variables associated with perinatal death.
  
  
  RESULTS
  Sixty-one patients were included in the study with 16 ending in perinatal death (26.2%). Ethnicity, maternal age, gravidity, parity, use of tobacco, use of cocaine, hypertension, asthma, diabetes, hepatitis C, sickle cell disease and abnormalities of amniotic fluid volume were not the main factors for perinatal mortality. Gestational age at delivery, birthweight and history of recent trauma were significantly associated with perinatal mortality. The perinatal mortality rate was 42% in patients who delivered prior to 30 weeks of gestation compared to 15% in patients who delivered after 30 weeks of gestation (p < 0.05). A three-fold increase in severe trauma was reported in the group of patients with perinatal mortality than in the group with perinatal survivors (25% versus 7%, respectively, p < 0.05).
  
  
  CONCLUSIONS
  In patients admitted to hospital for placental abruption delivery prior to 30 weeks of gestation and a history of abdominal trauma are independent risk factors for perinatal death.
authors.affiliation: Perinatal Institute, Jersey Shore University Medical Center , Neptune, NJ , USA and.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Atkinson
authors.forename: Joaquin
authors.initials: J
authors.lastname: Santolaya-Forgas
authors.forename: David N
authors.initials: DN
authors.lastname: Blitzer
authors.forename: Jacobo L
authors.initials: JL
authors.lastname: Santolaya
authors.forename: Paul
authors.initials: P
authors.lastname: Matta
authors.forename: Joseph
authors.initials: J
authors.lastname: Canterino
authors.forename: Yinka
authors.initials: Y
authors.lastname: Oyelese
mesh_terms: D000037:Abruptio Placentae / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality*; D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D054238:Perinatal Mortality; D011247:Pregnancy; D012307:Risk Factors; D055815:Young Adult
keywords: Perinatal mortality; placental abruption; prematurity; trauma in pregnancy