Epidemiology of placenta previa in the United States - Tips from Other Journals

Date: Oct, 1993

Although placenta previa is a leading cause of third-trimester bleeding and can result in serious maternal morbidity and increased risk of maternal, fetal and neonatal death, data on its incidence and sociodemographic risk factors have not been available. Iyasu and colleagues examined the epidemiology of placenta previa in the United States.

Data from the National Hospital Discharge Survey from 1979 through 1987 and the Retrospective Maternal Mortality Study from 1979 through 1986 were reviewed. An estimated 164,000 deliveries were complicated by placenta previa during this time frame; the average annual incidence rate was 4.8 cases per 1,000 deliveries.

Among black and other minority women, the average annual rate was 5.8 cases per 1,000 deliveries, compared with 4.5 cases per 1,000 deliveries among white women. Advancing maternal age was associated with an increased rate of placenta previa in all racial groups. The risk was nearly five times higher for women aged 35 years or older than for women younger than age 20. No association was found between the risk of placenta previa and marital status or expected source of payment.

The mean length of hospital stay was increased 2.2 days for vaginal deliveries and 3.5 days for cesarean deliveries when the pregnancy was complicated by placenta previa. Women with placenta previa were 14 times more likely than other women to have abruptio placentae; they also had an increased risk of cesarean section (rate ratio of 3.9), fetal malpresentation (2.8) and postpartum hemorrhage (1.7). Placenta previa was fatal in three of every 10,000 cases (0.03 percent). The immediate cause of death in these cases usually was uterine bleeding and disseminated intravascular coagulation.

The authors conclude that placenta previa results in many serious complications for fetuses and mothers. They believe further studies are needed to identify and implement preventive interventions in women who are at increased risk for placenta previa.

COPYRIGHT 1993 American Academy of Family PhysiciansCOPYRIGHT 2004 Gale Group

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