Preterm placental abruption and its association with adverse maternal and neonatal outcomes: a retrospective study

Abstract Background Placental abruption (PA), a severe obstetric complication, defined as the partial or complete detachment of a normally situated placenta from the uterine wall before birth, after 20 weeks of gestation, is associated with significant maternal and neonatal morbidity and mortality....

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Main Authors: Li Zhang, Hong Yang, Yong Sun, Shasha Liu
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Pregnancy and Childbirth
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Online Access:https://doi.org/10.1186/s12884-025-07718-6
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author Li Zhang
Hong Yang
Yong Sun
Shasha Liu
author_facet Li Zhang
Hong Yang
Yong Sun
Shasha Liu
author_sort Li Zhang
collection DOAJ
description Abstract Background Placental abruption (PA), a severe obstetric complication, defined as the partial or complete detachment of a normally situated placenta from the uterine wall before birth, after 20 weeks of gestation, is associated with significant maternal and neonatal morbidity and mortality. Despite its clinical importance, the pathogenesis of PA remains unclear, and there is limited research specifically comparing outcomes in term and preterm pregnancies with PA. This study aimed to evaluate maternal and neonatal outcomes in pregnancies complicated by PA on basis of the timing of PA onset, with a focus on differences between term and preterm deliveries. Methods This retrospective study included a total of 757 singleton pregnant women with confirmed PA from a tertiary obstetrics hospital care center between June 2020 to March 2024, who were classified into the preterm group (n = 300) and the full-term group (n = 457) based on their gestational age of PA onset. The baseline characteristics, maternal and newborn outcomes were collected from electronic health records in hospital information system, and further analyzed between two groups. The adjusted odds ratios (aORs) for the risk of adverse pregnancy outcomes on basis of term or preterm delivery in women with PA were analyzed by using multivariate logistic regression models. Results Women with preterm delivery had about 3 times greater risk for uterus-placenta apoplexy (aOR: 2.93, 95% CI 1.33–6.47, P = 0.01), 3 times greater risk for fetal growth restriction (aOR: 3.47, 95% CI 1.45–8.30, P = 0.01), 3 times greater risk for adult intensive care unit (ICU, aOR: 3.28, 95% CI 1.27–8.46, P = 0.01), and less chances to use oxytocin (aOR: 0.21, 95% CI 0.13–0.32, P < 0.01). Premature newborns had less chances to use forceps (aOR: 0.09, 95% CI 0.01–0.76, P = 0.02), but about 10 times greater risk for stillbirth (aOR: 9.38, 95% CI 1.10 − 79.68, P < 0.01). Conclusions Preterm pregnancies with PA are associated with higher risks of severe maternal complications and adverse neonatal outcomes, underscoring the need for enhanced clinical surveillance and timely intervention. Future research should focus on elucidating underlying mechanisms and developing effective prevention strategies, while long-term follow-up is essential to assess the health outcomes of affected infants. Clinical trial number Not applicable.
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spelling doaj-art-6bc480287cec495c9358749b58a081422025-08-20T03:22:04ZengBMCBMC Pregnancy and Childbirth1471-23932025-05-0125111010.1186/s12884-025-07718-6Preterm placental abruption and its association with adverse maternal and neonatal outcomes: a retrospective studyLi Zhang0Hong Yang1Yong Sun2Shasha Liu3Department of Obstetrics, Maternal and Child Health Hospital of Hubei ProvinceDepartment of Obstetrics, Maternal and Child Health Hospital of Hubei ProvinceDepartment of Obstetrics, Maternal and Child Health Hospital of Hubei ProvinceDepartment of Obstetrics, Maternal and Child Health Hospital of Hubei ProvinceAbstract Background Placental abruption (PA), a severe obstetric complication, defined as the partial or complete detachment of a normally situated placenta from the uterine wall before birth, after 20 weeks of gestation, is associated with significant maternal and neonatal morbidity and mortality. Despite its clinical importance, the pathogenesis of PA remains unclear, and there is limited research specifically comparing outcomes in term and preterm pregnancies with PA. This study aimed to evaluate maternal and neonatal outcomes in pregnancies complicated by PA on basis of the timing of PA onset, with a focus on differences between term and preterm deliveries. Methods This retrospective study included a total of 757 singleton pregnant women with confirmed PA from a tertiary obstetrics hospital care center between June 2020 to March 2024, who were classified into the preterm group (n = 300) and the full-term group (n = 457) based on their gestational age of PA onset. The baseline characteristics, maternal and newborn outcomes were collected from electronic health records in hospital information system, and further analyzed between two groups. The adjusted odds ratios (aORs) for the risk of adverse pregnancy outcomes on basis of term or preterm delivery in women with PA were analyzed by using multivariate logistic regression models. Results Women with preterm delivery had about 3 times greater risk for uterus-placenta apoplexy (aOR: 2.93, 95% CI 1.33–6.47, P = 0.01), 3 times greater risk for fetal growth restriction (aOR: 3.47, 95% CI 1.45–8.30, P = 0.01), 3 times greater risk for adult intensive care unit (ICU, aOR: 3.28, 95% CI 1.27–8.46, P = 0.01), and less chances to use oxytocin (aOR: 0.21, 95% CI 0.13–0.32, P < 0.01). Premature newborns had less chances to use forceps (aOR: 0.09, 95% CI 0.01–0.76, P = 0.02), but about 10 times greater risk for stillbirth (aOR: 9.38, 95% CI 1.10 − 79.68, P < 0.01). Conclusions Preterm pregnancies with PA are associated with higher risks of severe maternal complications and adverse neonatal outcomes, underscoring the need for enhanced clinical surveillance and timely intervention. Future research should focus on elucidating underlying mechanisms and developing effective prevention strategies, while long-term follow-up is essential to assess the health outcomes of affected infants. Clinical trial number Not applicable.https://doi.org/10.1186/s12884-025-07718-6Plcental abruptionPremature birthTerm birthHigh-risk pregnancy
spellingShingle Li Zhang
Hong Yang
Yong Sun
Shasha Liu
Preterm placental abruption and its association with adverse maternal and neonatal outcomes: a retrospective study
BMC Pregnancy and Childbirth
Plcental abruption
Premature birth
Term birth
High-risk pregnancy
title Preterm placental abruption and its association with adverse maternal and neonatal outcomes: a retrospective study
title_full Preterm placental abruption and its association with adverse maternal and neonatal outcomes: a retrospective study
title_fullStr Preterm placental abruption and its association with adverse maternal and neonatal outcomes: a retrospective study
title_full_unstemmed Preterm placental abruption and its association with adverse maternal and neonatal outcomes: a retrospective study
title_short Preterm placental abruption and its association with adverse maternal and neonatal outcomes: a retrospective study
title_sort preterm placental abruption and its association with adverse maternal and neonatal outcomes a retrospective study
topic Plcental abruption
Premature birth
Term birth
High-risk pregnancy
url https://doi.org/10.1186/s12884-025-07718-6
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AT hongyang pretermplacentalabruptionanditsassociationwithadversematernalandneonataloutcomesaretrospectivestudy
AT yongsun pretermplacentalabruptionanditsassociationwithadversematernalandneonataloutcomesaretrospectivestudy
AT shashaliu pretermplacentalabruptionanditsassociationwithadversematernalandneonataloutcomesaretrospectivestudy