Risk Factors Associated with Placenta Previa at Maharat Nakorn Ratchasima Hospital

Abstract

Objective: To determine the risk factors associated with placenta previa at Maharat Nakorn Ratchasima Hospital.

Design:  Retrospective case control study.

Materials and Methods:  This retrospective case control study had recruited 475 singleton pregnancies with placenta previa between January 2003 and December 2007 and another 422 randomly-selected uncomplicated singleton pregnancies as control. Data on potential risk factors for placenta previa development were carefully extracted from medical records, reviewed, and compared with the control group.

Results:  The incidence of placenta previa was 1.17%. Factors that significantly associated with placenta previa development were advanced maternal age (odds ratio 2.89, 95%CI 1.99-4.19), previous abortion (odds ratio 2.36, 95%CI 1.68-3.33) and uterine abnormalities (odds ratio 12.79, 95%CI 1.67-97.65). While grand multigravidity was found more frequent in the study group compared to the control group but without statistically significant. On the other hand, history of previous cesarean section was significantly less frequent in women with placenta previa than the control (p-value = 0.0119). Multiple maternal and perinatal morbidities, such as postpartum hemorrhage, blood transfusion, post-partum hysterectomy, fetal distress, low birth weight and preterm birth were increased significantly in the placenta previa group.

Conclusion: Factors significant associated with a placenta previa development were advanced maternal age, previous abortion and uterine abnormalities.