A Danish national cohort study on neonatal outcome in singleton pregnancies with placenta previa

• Published in: Acta obstetricia et gynecologica Scandinavica Vol. 91; no. 5; pp. 546 - 551
• Main Authors: NØRGAARD, LONE N., PINBORG, ANJA, LIDEGAARD, ØJVIND, BERGHOLT, THOMAS
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2012; Blackwell
• Subjects: Adult; Apgar Score; Biological and medical sciences; Birth control; Birth Weight; Case-Control Studies; Cesarean Section - statistics & numerical data; Cohort Studies; Delivery. Postpartum. Lactation; Denmark - epidemiology; Diseases of mother, fetus and pregnancy; Disorders; Female; Gestational Age; Gynecology. Andrology. Obstetrics; Humans; In vitro fertilization; Incidence; Infant Mortality; Infant, Newborn; Medical sciences; neonatal outcome; placenta previa; Placenta Previa - epidemiology; Pregnancy; Pregnancy Outcome - epidemiology; Pregnancy. Fetus. Placenta; preterm delivery; Registries; Risk Factors; small-for-gestational age; Sterility. Assisted procreation; Denmark; Europe; In vitro fertilization; Intrauterine growth retardation; Neonatal; Prognosis; Pregnancy disorders; Assisted procreation; Singleton pregnancy; Fetal diseases; Cohort study; Delivery disorders; preterm delivery; Human; small-for-gestational age; Placenta previa; Gynecology; Low birth weight; Premature delivery; neonatal outcome; Placenta diseases; Obstetrics; In vitro fertilization embryo transfer; Newborn diseases; Newborn; Prematurity; Danish
• ISSN: 0001-6349; 1600-0412
• DOI: 10.1111/j.1600-0412.2012.01375.x

Objective. To describe the incidence of placenta previa and to assess neonatal morbidity and mortality in pregnancies with placenta previa after adjustment for previous cesarean section, smoking, multiparity, maternal age and in vitro fertilization. Design. National cohort study. Setting. Danish national IVF‐, birth‐ and patient registers. Population. All pregnancies in Denmark from 1978–2006 and a subpopulation of all singleton pregnancies during the years 2001–2006 with placenta previa (n=1721) compared to pregnancies without this diagnosis. Methods. Incidence rates and multivariate analysis. Main outcome measures. Gestational age, birthweight, Apgar score after five minutes, stillbirth, neonatal mortality and admittance to neonatal intensive care unit. Results. The incidence of placenta previa in Denmark was 0.54% in 2006. Neonates born after pregnancies with placenta previa had a higher risk of being born at a gestational age below 37 weeks (OR 8.6; 95%CI 7.5–9.9), having an Apgar score of ≤7 at five minutes (OR 2.7; 95%CI 2.0–3.7), being transferred to a neonatal intensive care unit (OR 4.3; 95%CI 3.8–4.9) and for stillbirth and neonatal mortality combined (OR 1.8; 95%CI 1.1–3.0), compared with neonates born in pregnancies without placenta previa. No increased risk of being small‐for‐gestational age was found (OR 1.0; 95%CI 1.0–1.2). Conclusion. When adjusting for confounders, neonates born after pregnancies with placenta previa had a significantly higher risk of being born preterm, having a low Apgar score, being transferred to neonatal intensive care, and death.