Abruptio placentae – relationship with other placental dysfunction related conditions

Abstract

Objective: To investigate newborns’ sizes associated with abruptio placentae (AP) and to assess the association of a history of pregnancy induced hypertension (PIH) and low birth weight with the occurrence of AP and vice versa. Design: A cohort study based on the Medical Birth Registry of Norway. Results: AP in the first birth was associated with higher rates of AP, small for gestational age (SGA), and PIH in the second pregnancy. This was particularly evident for early onset preeclampsia (unadjusted odds ratio: 5.9; 95% confidence interval: 3.0–11.5). PIH in the first pregnancy was associated with higher rates of AP in the second. In women who delivered a newborn with weight below the 5th birth weight percentile, AP was 2–3 times more likely to occur than with birth weight percentiles 10–89.9. The occurrence of AP in the second pregnancy also increased with decreasing size at birth in the previous. Conclusions: A pregnancy subsequent to AP must be considered a risk pregnancy in terms of recurrent AP and excess risk of fetal growth restriction and PIH. In sibships with PIH, fetal growth restriction, or PA among siblings, the risk of AP is increased. This suggests a shared recurrent etiologic factor involving an abnormal feto-maternal relationship in AP, PIH, and fetal growth restriction.