Maternal, Labor, Delivery, and Perinatal Outcomes Associated with Placental Abruption: A Systematic Review.
ObjectiveRisk factors for placental abruption have changed, but there has not been an updated systematic review investigating outcomes.MethodsWe searched PubMed, EMBASE, Web of Science, SCOPUS, and CINAHL for publications from January 1, 2005 through December 31, 2016. We reviewed English-language publications reporting estimated incidence and/or risk factors for maternal, labor, delivery, and perinatal outcomes associated with abruption. We excluded case studies, conference abstracts, and studies that lacked a referent/comparison group or did not clearly characterize placental abruption.ResultsA total of 123 studies were included. Abruption was associated with elevated risk of cesarean delivery, postpartum hemorrhage and transfusion, preterm birth, intrauterine growth restriction or low birth weight, perinatal mortality, and cerebral palsy. Additional maternal outcomes included relaparotomy, hysterectomy, sepsis, amniotic fluid embolism, venous thromboembolism, acute kidney injury, and maternal intensive care unit admission. Additional perinatal outcomes included acidosis, encephalopathy, severe respiratory disorders, necrotizing enterocolitis, acute kidney injury, need for resuscitation, chronic lung disease, infant death, and epilepsy.ConclusionFew studies examined outcomes beyond the initial birth period, but there is evidence that both mother and child are at risk of additional adverse outcomes. There was also considerable variation in, or absence of, the reporting of abruption definitions.
Maternal and Child Health Program, University of Maryland, College Park, Maryland.|Department of Obstetrics and Gynecology, Center for Research in Reproduction and Women's Health, University of Pennsylvania, Philadelphia, Pennsylvania.|Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
Katheryne L
KL
Downes
Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
Katherine L
KL
Grantz
Maternal and Child Health Program, University of Maryland, College Park, Maryland.|Department of Epidemiology and Biostatistics, University of Maryland, College Park, Maryland.|Department of Epidemiology and Biostatistics, University of Maryland, Baltimore, Maryland.
Edmond D
ED
Shenassa
D000037:Abruptio Placentae / Q000453:epidemiology* / Q000209:etiology*; D001238:Asphyxia Neonatorum / Q000453:epidemiology / Q000209:etiology; D001803:Blood Transfusion; D002547:Cerebral Palsy / Q000453:epidemiology; D002585:Cesarean Section; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology; D006801:Humans; D002534:Hypoxia, Brain / Q000453:epidemiology / Q000209:etiology; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008428:Maternal Mortality; D054238:Perinatal Mortality; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology; D012008:Recurrence; D050497:Stillbirth / Q000453:epidemiology