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Placental Abruption as a Significant Risk Factor for Long‐term Cardiovascular Mortality in a Follow‐up Period of More Than a Decade
Author(s) -
Pariente Gali,
ShohamVardi Ilana,
Kessous Roy,
Sherf Michael,
Sheiner Eyal
Publication year - 2014
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/ppe.12089
Subject(s) - medicine , placental abruption , proportional hazards model , odds ratio , obstetrics , hazard ratio , risk factor , incidence (geometry) , confidence interval , population , gynecology , pregnancy , gestation , genetics , physics , environmental health , optics , biology
Background To investigate the risk for subsequent cardiovascular events in women having placental abruption during a follow‐up period of more than 10 years. Methods A population‐based study of the incidence of cardiovascular events in women who had placental abruption with women without placental abruption during 1988–99 and with follow‐up until 2010. Associations between placental abruption and maternal long‐term cardiovascular morbidity and mortality were investigated. Kaplan–Meier survival curves and multivariable Cox regression were used to estimate cumulative incidence of cardiovascular mortality. Results During the study period, there were 47 585 deliveries meeting the inclusion criteria; of these, 653 occurred in patients with placental abruption. No significant association was noted between placental abruption and subsequent long‐term hospitalisations because of cardiovascular causes. However, placental abruption was associated with long‐term cardiovascular mortality [odds ratio ( OR ) = 6.6; 95% confidence interval ( CI ) 2.3, 18.3]. The cardiovascular case fatality rate for the placental abruption group was 13.0% vs. 2.5% in the comparison group ( P < 0.001). Patients with a history of placental abruption had a significantly higher risk for cardiovascular mortality during the follow‐up period (Log‐rank test P = 0.017). Using Cox multivariable regression models, placental abruption remained an independent risk factor for long‐term maternal cardiovascular mortality [adjusted hazard ratio ( HR ) = 4.3; 95% CI 1.1, 18.6). Conclusion Placental abruption is a significant risk factor for long‐term cardiovascular mortality in a follow‐up period of more than a decade.