Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: A case-control study

Farquhar, CM; Li, Z; Lensen, S; McLintock, C; Pollock, W; Peek, MJ; Ellwood, D; Knight, M; Homer, CS; Vaughan, G; Wang, A; Sullivan, E

Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: A case-control study

Farquhar, CM Li, Z

Lensen, S McLintock, C Pollock, W Peek, MJ Ellwood, D Knight, M Homer, CS

Vaughan, G

Wang, A

Sullivan, E

Permalink

Publication Type:: Journal Article
Citation:: BMJ Open, 2017, 7 (10)
Issue Date:: 2017-10-01

Open Access

Copyright Clearance Process

Recently Added
In Progress
Open Access

This item is open access.

Adobe PDF

Download Published VersionAdobe PDF (343.83 kB)

View on publisher's site

View statistics

Full metadata record

Field	Value	Language
dc.contributor.author	Farquhar, CM	en_US
dc.contributor.author	Li, Z https://orcid.org/0000-0002-7622-150X	en_US
dc.contributor.author	Lensen, S	en_US
dc.contributor.author	McLintock, C	en_US
dc.contributor.author	Pollock, W	en_US
dc.contributor.author	Peek, MJ	en_US
dc.contributor.author	Ellwood, D	en_US
dc.contributor.author	Knight, M	en_US
dc.contributor.author	Homer, CS https://orcid.org/0000-0002-7454-3011	en_US
dc.contributor.author	Vaughan, G https://orcid.org/0000-0002-0132-9946	en_US
dc.contributor.author	Wang, A https://orcid.org/0000-0002-3656-4284	en_US
dc.contributor.author	Sullivan, E https://orcid.org/0000-0002-8718-2753	en_US
dc.date.issued	2017-10-01	en_US
dc.identifier.citation	BMJ Open, 2017, 7 (10)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/118773
dc.description.abstract	© Article author(s) 2017. Objective Estimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes. Design Case-control study. Setting Sites in Australia and New Zealand with at least 50 births per year. Participants 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. Methods Data were collected using the Australasian Maternity Outcomes Surveillance System. Primary and secondary outcome measures Incidence, risk factors (eg, prior caesarean section (CS), maternal age) and clinical outcomes of placenta accreta (eg CS, hysterectomy and death). Results 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.	en_US
dc.relation	http://purl.org/au-research/grants/nhmrc/510298
dc.relation.ispartof	BMJ Open	en_US
dc.relation.isbasedon	10.1136/bmjopen-2017-017713	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Placenta Accreta	en_US
dc.subject.mesh	Pregnancy Outcome	en_US
dc.subject.mesh	Cesarean Section	en_US
dc.subject.mesh	Incidence	en_US
dc.subject.mesh	Multivariate Analysis	en_US
dc.subject.mesh	Logistic Models	en_US
dc.subject.mesh	Risk Factors	en_US
dc.subject.mesh	Case-Control Studies	en_US
dc.subject.mesh	Maternal Age	en_US
dc.subject.mesh	Parity	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Pregnancy, Multiple	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	New Zealand	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Placenta Previa	en_US
dc.subject.mesh	Young Adult	en_US
dc.title	Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: A case-control study	en_US
dc.type	Journal Article
utslib.citation.volume	10	en_US
utslib.citation.volume	7	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1199 Other Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Strength - WHO CC
utslib.copyright.status	open_access
dcterms.license	This work is distributed under a Creative Commons Attribution Non Commercial license (CC BY-NC) http://creativecommons.org/licenses/by-nc/4.0/
pubs.issue	10	en_US
pubs.publication-status	Published	en_US
pubs.volume	7	en_US

Abstract:

© Article author(s) 2017. Objective Estimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes. Design Case-control study. Setting Sites in Australia and New Zealand with at least 50 births per year. Participants 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. Methods Data were collected using the Australasian Maternity Outcomes Surveillance System. Primary and secondary outcome measures Incidence, risk factors (eg, prior caesarean section (CS), maternal age) and clinical outcomes of placenta accreta (eg CS, hysterectomy and death). Results 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.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/118773