American Journal of Epidemiology Vol. 134, No. 9: 965-972
Copyright © 1991 by The Johns Hopkins University School of Hygiene and Public Health
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Risk Factors for Abruptio Placentae
1Department of Epidemiology, Harvard University School of Public Health Boston, MA
2Department of Maternal and Child Health, Harvard University School of Public Health Boston, MA
3Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School Boston MA
4St. Margaret's Hospital for Women, Tufts University School of Medicice Boston MA
5Harvard Community Health Plan Boston, MA
Reprint requests to Dr. Michelle A. Williams, Department of Epidemiology, Harvard University School of Public Health, Boston, MA 02115
The authors studied the relation of sociodemographic, medical, and life-style factors and abruptio placentae in a large cross-sectional data base. The 143 cases of abruption identified in the Delivery Interview Program, conducted in Boston from 1977 to 1980, were compared with 1,257 randomly selected controls. The authors used multiple logistic regression techniques to derive maximum likelihood estimates of the adjusted odds ratios and 95% confidence intervals as measures of the association between exposure factors and abruption. A history of chronic hypertension was associated with a threefold increase in risk (odds ratio (OR) = 3.1, 95% confidence interval (Cl) 1.1–8.4), but pregnancy-induced hypertension was not associated with abruption. Excess risk was associated with advanced maternal age (OR = 2.3, 95% Cl 1.3–3.9), low prepregnancy body mass index (OR = 2.3, 95% Cl 1.3–4.1), a history of prior stillbirth (OR = 3.5, 95% Cl 1.8–7.0), and at least weekly use of marijuana during pregnancy (OR = 2.8, 95% Cl 1.2–6.6). Overall, the association with cigarette smoking during pregnancy was of only borderline stgnificance (OR = 1.5, 95% Cl 1.0–2.2), although there appeared to be a dose-response relation between the number of cigarettes smoked and risk of abruption.
abruptio placentae; pregnancy, pregnancy complications; risk factors
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