title: Placenta accreta is an independent risk factor for late pre-term birth and perinatal mortality.
abstract: OBJECTIVE
  This study is aimed to identify the risk factors for the development of placenta accreta (PA) and characterize its effect on maternal and perinatal outcomes.
  
  
  METHODS
  This population-based retrospective cohort study included all deliveries at our medical center during the study period. Those with placenta accreta (n = 551) comprised the study group, while the rest of the deliveries (n = 239 089) served as a comparison group.
  
  
  RESULTS
  The prevalence of placenta accerta is 0.2%. Women with this complication had higher rates of ≥2 previous CS (p < 0.001), recurrent abortions (p = 0.03), and previous placenta accreta [p < 0.001]. The rates of placenta previa and peripartum hemorrhage necessitating blood transfusion were higher in women with placenta accreta than in the comparison group. PTB before 34 and 37 weeks of gestation was more common among women with placenta accreta (p < 0.01), as was the rate of perinatal mortality (p < 0.001). Placenta accreta was an independent risk factor for perinatal mortality (adj. OR 8.2; 95% CI 6.4-10.4, p < 0.001) and late PTB (adj. OR 1.4; 95% CI 1.1-1.7, p = 0.002).
  
  
  CONCLUSIONS
  Placenta accreta is an independent risk factor for late PTB and perinatal mortality.
authors.affiliation: a Faculty of Health Sciences , School of Medicine, Ben Gurion University of the Negev , Beer Sheva , Israel .
authors.forename: Adi
authors.initials: A
authors.lastname: Vinograd
authors.forename: Tamar
authors.initials: T
authors.lastname: Wainstock
authors.forename: Moshe
authors.initials: M
authors.lastname: Mazor
authors.forename: Ruthy
authors.initials: R
authors.lastname: Beer-Weisel
authors.forename: Vered
authors.initials: V
authors.lastname: Klaitman
authors.forename: Doron
authors.initials: D
authors.lastname: Dukler
authors.forename: Batel
authors.initials: B
authors.lastname: Hamou
authors.forename: Lena
authors.initials: L
authors.lastname: Novack
authors.forename: Neta
authors.initials: N
authors.lastname: Ben-Shalom Tirosh
authors.forename: Ofir
authors.initials: O
authors.lastname: Vinograd
authors.forename: Offer
authors.initials: O
authors.lastname: Erez
mesh_terms: D000026:Abortion, Habitual / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D054238:Perinatal Mortality; D010921:Placenta Accreta / Q000453:epidemiology* / Q000503:physiopathology; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology*; D012008:Recurrence; D012307:Risk Factors
keywords: DIC; hysterectomy; increta; maternal complication; obstetric outcome; percreta; placenta accreta; post-partum hemorrhage