Factors associated with poorer childbirth outcomes in pregnant women diagnosed with placenta previa

Abstract

Objective: Placenta previa is a health issue during pregnancy when the placenta wholly or partially covers the opening of the uterus. It can result in bleeding during pregnancy or after delivery, and preterm delivery. This study aimed to investigate the risk factors correlated with poorer childbirth outcomes of placenta previa. Materials and methods: Between May 2019 and January 2021, pregnant women diagnosed with placenta previa in our hospital were enrolled. Outcomes were postpartum hemorrhage after childbirth, and lower Apgar score and preterm delivery of the neonate. Laboratory blood examination data preoperatively were collected from medical records. Results: A total of 131 subjects were included, with a median age 31 years. Multivariate analysis showed that fibrinogen reduced risk for postpartum hemorrhage (adjusted odds ratio (aOR): 0.45, 95% confidence interval (CI): 0.26–0.79, p = 0.005). Homocysteine (aOR: 0.73, 95% CI: 0.54–0.99, p = 0.04) reduced the risk while D-dimer (aOR: 1.19, 95% CI: 1.02–1.37, p = 0.02) increased the risk for low Apgar score. Age (aOR: 0.86, 95% CI: 0.77–0.96, p = 0.005) decreased the risk but history of full-term pregnancy more than twice (aOR: 8.58, 95% CI: 2.32–31.71, p = 0.001) increased the risk for preterm delivery. Conclusion: The findings suggest that poorer childbirth outcomes in pregnant women with placenta previa are associated with young age, history of full-term pregnancy, and preoperative concentrations of low fibrinogen, low homocysteine and high D-dimer. This provides obstetricians adjunctive information for early screening of high-risk population and relevant treatment arrangement in advance.

Keywords

• Placenta previa
• Postpartum hemorrhage
• Preterm delivery
• Fibrinogen
• Homocysteine
• D-dimer