Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control study
<strong>Objective</strong> Estimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes. <strong>Design</strong> Case–control study. <strong>Setting</strong> Sites in Australia and New Zealand with at least 50 bi...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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BMJ Publishing Group
2017
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| _version_ | 1797051444567736320 |
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| author | Farquhar, C Li, Z Lensen, S McLintock, C Pollock, W Peek, M Ellwood, D Knight, M Homer, C Vaughan, G Wang, A Sullivan, E |
| author_facet | Farquhar, C Li, Z Lensen, S McLintock, C Pollock, W Peek, M Ellwood, D Knight, M Homer, C Vaughan, G Wang, A Sullivan, E |
| author_sort | Farquhar, C |
| collection | OXFORD |
| description | <strong>Objective</strong> Estimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes. <strong>Design</strong> Case–control study. <strong>Setting</strong> Sites in Australia and New Zealand with at least 50 births per year. <strong>Participants</strong> Cases were women giving birth (≥20 weeks or fetus ≥400 g) who were diagnosed with placenta accreta by antenatal imaging, at operation or by pathology specimens between 2010 and 2012. Controls were two births immediately prior to a case. A total of 295 cases were included and 570 controls. <strong>Methods</strong> Data were collected using the Australasian Maternity Outcomes Surveillance System. <strong>Primary and secondary outcome measures</strong> Incidence, risk factors (eg, prior caesarean section (CS), maternal age) and clinical outcomes of placenta accreta (eg CS, hysterectomy and death). <strong>Results</strong> The incidence of placenta accreta was 44.2/100 000 women giving birth (95% CI 39.4 to 49.5); however, this may overestimated due to the case definition used. In primiparous women, an increased odds of placenta accreta was observed in older women (adjusted OR (AOR) women≥40 vs <30: 19.1, 95% CI 4.6 to 80.3) and current multiple birth (AOR: 6.1, 95% CI 1.1 to 34.1). In multiparous women, independent risk factors were prior CS (AOR ≥2 prior sections vs 0: 13.8, 95% CI 7.4 to 26.1) and current placenta praevia (AOR: 36.3, 95% CI 14.0 to 93.7). There were two maternal deaths (case fatality rate 0.7%). Women with placenta accreta were more likely to have a caesarean section (AOR: 4.6, 95% CI 2.7 to 7.6) to be admitted to the intensive care unit (ICU)/high dependency unit (AOR: 46.1, 95% CI 22.3 to 95.4) and to have a hysterectomy (AOR: 209.0, 95% CI 19.9 to 875.0). Babies born to women with placenta accreta were more likely to be preterm, be admitted to neonatal ICU and require resuscitation. |
| first_indexed | 2024-03-06T18:19:40Z |
| format | Journal article |
| id | oxford-uuid:05d76b3b-1872-4a9f-9795-29f3c68a414f |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T18:19:40Z |
| publishDate | 2017 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:05d76b3b-1872-4a9f-9795-29f3c68a414f2022-03-26T08:59:27ZIncidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:05d76b3b-1872-4a9f-9795-29f3c68a414fEnglishSymplectic Elements at OxfordBMJ Publishing Group2017Farquhar, CLi, ZLensen, SMcLintock, CPollock, WPeek, MEllwood, DKnight, MHomer, CVaughan, GWang, ASullivan, E<strong>Objective</strong> Estimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes. <strong>Design</strong> Case–control study. <strong>Setting</strong> Sites in Australia and New Zealand with at least 50 births per year. <strong>Participants</strong> Cases were women giving birth (≥20 weeks or fetus ≥400 g) who were diagnosed with placenta accreta by antenatal imaging, at operation or by pathology specimens between 2010 and 2012. Controls were two births immediately prior to a case. A total of 295 cases were included and 570 controls. <strong>Methods</strong> Data were collected using the Australasian Maternity Outcomes Surveillance System. <strong>Primary and secondary outcome measures</strong> Incidence, risk factors (eg, prior caesarean section (CS), maternal age) and clinical outcomes of placenta accreta (eg CS, hysterectomy and death). <strong>Results</strong> The incidence of placenta accreta was 44.2/100 000 women giving birth (95% CI 39.4 to 49.5); however, this may overestimated due to the case definition used. In primiparous women, an increased odds of placenta accreta was observed in older women (adjusted OR (AOR) women≥40 vs <30: 19.1, 95% CI 4.6 to 80.3) and current multiple birth (AOR: 6.1, 95% CI 1.1 to 34.1). In multiparous women, independent risk factors were prior CS (AOR ≥2 prior sections vs 0: 13.8, 95% CI 7.4 to 26.1) and current placenta praevia (AOR: 36.3, 95% CI 14.0 to 93.7). There were two maternal deaths (case fatality rate 0.7%). Women with placenta accreta were more likely to have a caesarean section (AOR: 4.6, 95% CI 2.7 to 7.6) to be admitted to the intensive care unit (ICU)/high dependency unit (AOR: 46.1, 95% CI 22.3 to 95.4) and to have a hysterectomy (AOR: 209.0, 95% CI 19.9 to 875.0). Babies born to women with placenta accreta were more likely to be preterm, be admitted to neonatal ICU and require resuscitation. |
| spellingShingle | Farquhar, C Li, Z Lensen, S McLintock, C Pollock, W Peek, M Ellwood, D Knight, M Homer, C Vaughan, G Wang, A Sullivan, E Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control study |
| title | Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control study |
| title_full | Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control study |
| title_fullStr | Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control study |
| title_full_unstemmed | Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control study |
| title_short | Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control study |
| title_sort | incidence risk factors and perinatal outcomes for placenta accreta in australia and new zealand a case control study |
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