caa a22 4500 445309318 CHVBK 20180317142623.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s00404-010-1598-7 doi (NATIONALLICENCE)springer-10.1007/s00404-010-1598-7 Critical analysis of risk factors and outcome of placenta previa [Elektronische Daten] [Tom Rosenberg, Gali Pariente, Ruslan Sergienko, Arnon Wiznitzer, Eyal Sheiner] Objective: To investigate risk factors and pregnancy outcome of patients with placenta previa. Methods: A population-based study comparing all singleton pregnancies of women with and without placenta previa was conducted. Stratified analysis using multiple logistic regression models was performed to control for confounders. Results: During the study period, there were 185,476 deliveries, of which, 0.42% were complicated with placenta previa. Using a multivariable analysis with backward elimination, the following risk factors were independently associated with placenta previa: infertility treatments (OR 1.97; 95% CI 1.45-2.66; P<0.001), prior cesarean delivery (CD; OR 1.76; 95% CI 1.48-2.09; P<0.001) and advanced maternal age (OR 1.08; 95% CI 1.07-1.09; P<0.001). Placenta previa was significantly associated with adverse outcomes such as peripartum hysterectomy (5.3 vs. 0.04%; P<0.001), previous episode of second trimester bleeding (3.9 vs. 0.05%; P<0.001), blood transfusion (21.9 vs. 1.2%; P<0.001), maternal sepsis (0.4 vs. 0.02%; P<0.001), vasa previa (0.5 vs. 0.1%; P<0.001), malpresentation (19.8 vs. 5.4%; P<0.001), postpartum hemorrhage (1.4 vs. 0.5%; P=0.001) and placenta accreta (3.0 vs. 1.3%; P<0.001). Placenta previa was significantly associated with adverse perinatal outcomes such as higher rates of perinatal mortality (6.6 vs. 1.3%; P<0.001), an Apgar score <7 after 1 and 5min (25.3 vs. 5.9%; P<0.001, and 7.1 vs. 2.6%, P<0.001, respectively), congenital malformations (11.5 vs. 5.1%; P<0.001) and intrauterine growth restriction (3.6 vs. 2.1%; P=0.003). Using another multivariable logistic regression model, with perinatal mortality as the outcome variable, controlling for confounders, such as preterm birth, maternal age, etc., placenta previa was not found as an independent risk factor for perinatal mortality (weighted OR 1.018; 95% CI 0.74-1.40; P=0.910). Conclusions: Infertility treatments, prior cesarean section, and advanced maternal age are independent risk factors for placenta previa. An increase in the incidence of these risk factors probably contributes to a rise in the number of pregnancies complicated with placenta previa and its association with adverse maternal and perinatal outcomes. Careful surveillance of these risk factors is recommended with timely delivery in order to reduce the associated complications. Springer-Verlag, 2010 Placenta previa nationallicence Fertility treatments nationallicence Cesarean section nationallicence Advanced maternal age nationallicence Perinatal mortality nationallicence Pregnancy outcome nationallicence Rosenberg Tom Department of Obstetrics and Gynecology, Soroka University Medical Center, P.O Box 151, Be'er-Sheva, Israel aut Pariente Gali Department of Obstetrics and Gynecology, Soroka University Medical Center, P.O Box 151, Be'er-Sheva, Israel aut Sergienko Ruslan Department of Obstetrics and Gynecology, Soroka University Medical Center, P.O Box 151, Be'er-Sheva, Israel aut Wiznitzer Arnon Department of Obstetrics and Gynecology, Soroka University Medical Center, P.O Box 151, Be'er-Sheva, Israel aut Sheiner Eyal Department of Obstetrics and Gynecology, Soroka University Medical Center, P.O Box 151, Be'er-Sheva, Israel aut Archives of Gynecology and Obstetrics Springer-Verlag 284/1(2011-07-01), 47-51 0932-0067 284:1<47 2011 284 404 https://doi.org/10.1007/s00404-010-1598-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-010-1598-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Rosenberg Tom Department of Obstetrics and Gynecology, Soroka University Medical Center, P.O Box 151, Be'er-Sheva, Israel aut NATIONALLICENCE 700 1- Pariente Gali Department of Obstetrics and Gynecology, Soroka University Medical Center, P.O Box 151, Be'er-Sheva, Israel aut NATIONALLICENCE 700 1- Sergienko Ruslan Department of Obstetrics and Gynecology, Soroka University Medical Center, P.O Box 151, Be'er-Sheva, Israel aut NATIONALLICENCE 700 1- Wiznitzer Arnon Department of Obstetrics and Gynecology, Soroka University Medical Center, P.O Box 151, Be'er-Sheva, Israel aut NATIONALLICENCE 700 1- Sheiner Eyal Department of Obstetrics and Gynecology, Soroka University Medical Center, P.O Box 151, Be'er-Sheva, Israel aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 284/1(2011-07-01), 47-51 0932-0067 284:1<47 2011 284 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer