Abstract
Purpose
Immediate neonatal outcome in pregnancies complicated by placenta previa is largely dependent on gestational age. We aimed to investigate whether placenta previa increases the risk for perinatal mortality and immediate morbidity of the offspring born at term.
Methods
A population-based cohort study included all singleton pregnancies, with and without placenta previa, delivered at term. Maternal and pregnancy characteristics as well as immediate neonatal morbidity and mortality were compared. Deliveries occurred between the years 1991–2013 in a tertiary medical center. Multiple pregnancies, and fetal congenital malformations were excluded.
Results
During the study period 233,123 consecutive term deliveries met the inclusion criteria; 0.2 % of the babies were born to mothers diagnosed with placenta previa. Women with placenta previa were significantly older and more likely to have had a previous cesarean section. Pregnancies were more likely to be complicated with pathological presentations and cesarean hysterectomies. Babies born at term following pregnancies with placenta previa were more likely to weigh less than 2500 g (OR 2.78 CI 1.9–3.9, p < 0.001). However, 5 min Apgar score and perinatal mortality rates were comparable between the groups. Neonatal outcomes remained comparable between the groups in a sub-analysis of cesarean deliveries only.
Conclusion
Although placenta previa pregnancies involve higher maternal morbidity rates, term offsprings are not at an increased risk for immediate adverse outcome.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Faiz AS, Ananth CV (2003) Etiology and risk factors for placenta previa: an overview and meta-analysis of observational studies. J Matern Fetal Neonat Med 13:175
Rosenberg T, Pariente G, Sergienko R, Wiznitzer A, Sheiner E (2011) Critical analysis of risk factors and outcome of placenta previa. Arch Gynecol Obstet 284(1):47–51
Ananth CV, Smulian JC, Vintzileos AM (1997) The association of placenta previa with history of cesarean delivery and abortion: a metaanalysis. Am J Obstet Gynecol 177(5):1071–1078
Ananth CV, Demissie K, Smulian JC, Vintzileos AM (2003) Placenta previa in singleton and twin births in the United States, 1989 through 1998: a comparison of risk factor profiles and associated conditions. Am J Obstet Gynecol 188(1):275–281
Sheiner E, Shoham-Vardi I, Hallak M, Hershkowitz R, Katz M, Mazor M (2001) Placenta previa: obstetric risk factors and pregnancy outcome. J Matern Fetal Neonat Med 10(6):414–419
Downes KL, Hinkle SN, Sjaarda LA, Albert PS, Grantz KL (2015) Previous prelabor or intrapartum cesarean delivery and risk of placenta previa. Am J Obstet Gynecol 212(5):669.e1–e6
Rose GL, Chapman MG (1986) Aetiological factors in placenta praevia—a case controlled study. Br J Obstet Gynaecol 93(6):586–588
Ananth CV, Vintzileos AM (2006) Maternal-fetal conditions necessitating a medical intervention resulting in preterm birth. Am J Obstet Gynecol 195:1557–1563
Koifman A, Levy A, Zaulan Y, Harlev A, Mazor M, Wiznitzer A et al (2008) The clinical significance of bleeding during the second trimester of pregnancy. Arch Gynecol Obstet 278(1):47–51
Salihu HM, Li Q, Rouse DJ, Alexander GR (2003) Placenta previa: neonatal death after live births in the United States. Am J Obstet Gynecol 188(5):1305–1309
Statistics TCBo. Israel in Figures 2013. http://www.cbs.gov.il/www/publications/isr_in_n13e.pdf. Accessed May 25 2015
Vahanian SA, Lavery JA, Ananth CV, Vintzileos A (2015) Placental implantation abnormalities and risk of preterm delivery: a systematic review and metaanalysis. Am J Obstet Gynecol 213(4 Suppl):S78–S90
Cotton DB, Read JA, Paul RH, Quilligan EJ (1980) The conservative aggressive management of placenta previa. Am J Obstet Gynecol 137(6):687
Brenner WE, Edelman DA, Hendricks CH (1978) Characteristics of patients with placenta previa and results of “expectant management”. Am J Obstet Gynecol 132(2):180
Varma TR (1973) Fetal growth and placental function in patients with placenta praevia. J Obstet Gynaecol Br Commonw 80(4):311
Newton ER, Barss V, Cetrulo CL (1984) The epidemiology and clinical history of asymptomatic midtrimester placenta previa. Am J Obstet Gynecol 148(6):743
Ananth CV, Demissie K, Smulian JC, Vintzileos AM (2001) Relationship among placenta previa, fetal growth restriction, and preterm delivery: a population-based study. Obstet Gynecol 98(2):299
Räisänen S, Kancherla V, Kramer MR, Gissler M, Heinonen S (2014) Placenta previa and the risk of delivering a small-for-gestational-age newborn. Obstet Gynecol 124(2 Pt 1):285
Harper LM, Odibo AO, Macones GA, Crane JP, Cahill AG (2010) Effect of placenta previa on fetal growth. Am J Obstet Gynecol 203(4):330.e1
Nørgaard LN, Pinborg A, LidegaardØ Bergholt T (2012) A Danish national cohort study on neonatal outcome in singleton pregnancies with placenta previa. Acta Obstet Gynecol Scand 91(5):546
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors report no conflict of interests.
Rights and permissions
About this article
Cite this article
Walfisch, A., Sheiner, E. Placenta previa and immediate outcome of the term offspring. Arch Gynecol Obstet 294, 739–744 (2016). https://doi.org/10.1007/s00404-016-4044-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-016-4044-7