Maternal serum markers, characteristics and morbidly adherent placenta in women with previa.
OBJECTIVE
To examine associations with morbidly adherent placenta (MAP) among women with placenta previa.


METHODS
Women with MAP (cases) and previa alone (controls) were identified from a cohort of 236,714 singleton pregnancies with both first and second trimester prenatal screening, and live birth and hospital discharge records; pregnancies with aneuploidies and neural tube or abdominal wall defects were excluded. Logistic binomial regression was used to compare cases with controls.


RESULTS
In all, 37 cases with MAP and 699 controls with previa alone were included. Risk for MAP was increased among multiparous women with pregnancy-associated plasma protein-A (PAPP-A) ⩾95th percentile (⩾2.63 multiple of the median (MoM); adjusted OR (aOR) 8.7, 95% confidence interval (CI) 2.8 to 27.4), maternal-serum alpha fetoprotein (MS-AFP) ⩾95th percentile (⩾1.79 MoM; aOR 2.8, 95% CI 1.0 to 8.0), and 1 and ⩾2 prior cesarean deliveries (CDs; aORs 4.4, 95% CI 1.5 to 13.6 and 18.4, 95% CI 5.9 to 57.5, respectively).


CONCLUSIONS
Elevated PAPP-A, elevated MS-AFP and prior CDs are associated with MAP among women with previa.
Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.
D J
DJ
Lyell
Department of Obstetrics and Gynecology, University of Colorado Denver, Aurora, CO, USA.
A M
AM
Faucett
Genetic Disease Screening Program, California Department of Public Health, Richmond, CA, USA.
R J
RJ
Baer
Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.
Y J
YJ
Blumenfeld
Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.
M L
ML
Druzin
Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.
Y Y
YY
El-Sayed
Department of Pediatrics, Stanford University, Stanford, CA, USA.
G M
GM
Shaw
Genetic Disease Screening Program, California Department of Public Health, Richmond, CA, USA.
R J
RJ
Currier
1] Genetic Disease Screening Program, California Department of Public Health, Richmond, CA, USA [2] Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA.
L L
LL
Jelliffe-Pawlowski
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D002140:California; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D010921:Placenta Accreta / Q000097:blood*; D010923:Placenta Previa / Q000097:blood*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D011296:Prenatal Diagnosis; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000032:analysis
D015415:Biomarkers; D000509:alpha-Fetoproteins; D011266:Pregnancy-Associated Plasma Protein-A