American Journal of Epidemiology Vol. 153, No. 8 : 771-778
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Placental Abruption among Singleton and Twin Births in the United States: Risk Factor Profiles
1 Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, Robert Wood Johnson Medical School/Saint Peter's University Hospital, University of Medicine and Dentistry of New Jersey (UMDNJ), New Brunswick, NJ.
2 Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Robert Wood Johnson Medical School/Saint Peter's University Hospital, UMDNJ, New Brunswick, NJ.
3 Department of Environmental and Community Medicine, Robert Wood Johnson Medical School, UMDNJ, New Brunswick, NJ.
The authors performed a population-based epidemiologic study to evaluate and contrast risk factor profiles for placental abruption among singleton and twin gestations. Data were derived from linked US birth/infant death files for 1995 and 1996, comprising 7,465,858 singleton births and 193,266 twin births. The authors also evaluated effect modification between smoking and hypertension and the effect of a dose-response relation with number of cigarettes smoked daily on abruption risk. Abruption was recorded in 5.9 per 1,000 singleton births and 12.2 per 1,000 twin births. Risk factors for abruption among singleton and twin births, respectively, included preterm premature rupture of membranes (adjusted relative risks (RRs) = 4.89 and 2.01), eclampsia (RRs = 3.58 and 1.67), anemia (RRs = 2.23 and 2.33), hydramnios (RRs = 2.04 and 1.66), renal disorders (RRs = 1.54 and 2.56), and intrapartum fever (>100°F) (RRs = 1.17 and 1.69). Chronic hypertension (RR = 2.38) and pregnancy-induced hypertension (RR = 2.34) were risk factors for abruption in singleton births but not in twin births. Number of cigarettes smoked daily demonstrated a dose-response trend for abruption risk in singletons and twins. Abruption was more likely to occur among smokers with chronic hypertension (RRs = 4.66 and 3.15) and eclampsia (RRs = 6.28 and 5.08). The authors conclude that abruption is twice as likely to occur in twins as in singletons with differing risk factor profiles. This suggests that abruption in twins may result from different pathophysiologic processes.
abruptio placentae; pregnancy; risk factors; twins
Abbreviations: PROM, premature rupture of membranes
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  H.M. Salihu, O. Lynch, A.P. Alio, J.L. Kornosky, H.B. Clayton, and A.K. Mbah Extreme obesity and risk of placental abruption Hum. Reprod., February 1, 2009; 24(2): 438 - 444. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. V. Ananth and S. Cnattingius Influence of Maternal Smoking on Placental Abruption in Successive Pregnancies: A Population-based Prospective Cohort Study in Sweden Am. J. Epidemiol., August 1, 2007; 166(3): 289 - 295. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T.-H. Hung, C.-C. Hsieh, J.-J. Hsu, L.-M. Lo, T.-H. Chiu, and T.-T. Hsieh Risk Factors for Placental Abruption in an Asian Population Reproductive Sciences, January 1, 2007; 14(1): 59 - 65. [Abstract] [PDF]
|
|
|
|
|
|
P.-Y. Ancel, N. Lelong, E. Papiernik, M.-J. Saurel-Cubizolles, and M. Kaminski History of induced abortion as a risk factor for preterm birth in European countries: results of the EUROPOP survey Hum. Reprod., March 1, 2004; 19(3): 734 - 740. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. H. James Offspring sex ratios and the causes of placental pathology: the case of placental abruption Hum. Reprod., September 1, 2001; 16(9): 2031 - 2031. [Full Text] [PDF]
|
|