03727nam a22005897a 4500
180118s20172017 xxu||||| |||| 00| 0 eng d
0002-9262
10.1093/aje/kwx202 [doi]
3863300 [pii]
Ovid MEDLINE(R)
28595292
Neonatal Outcomes Associated With Placental Abruption.
American Journal of Epidemiology. 186(12):1319-1328, 2017 Dec 15
Am J Epidemiol. 186(12):1319-1328, 2017 Dec 15
American journal of epidemiology
2017
FY2018
2018-01-18
Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
Placental abruption (early separation of the placenta) is associated with preterm birth and perinatal mortality, but associations with other neonatal morbidities remain understudied. We examined the association between abruption and newborn outcomes. We analyzed 223,341 singleton deliveries from the Consortium on Safe Labor study, a retrospective, multisite, observational study (2002-2008) of electronic medical records in the United States. Adjusted relative risks, incidence rate ratios, and 99% confidence intervals were estimated. Direct effects attributable to abruption were examined by conditioning on intermediates (preterm birth and small for gestational age) with sensitivity analyses. Incidence of abruption was 1.6% (n = 3,619). Abruption was associated with an elevated risk of newborn resuscitation (relative risk (RR) = 1.5, 99% confidence interval (CI): 1.5, 1.6), apnea (RR = 5.8, 99% CI: 5.1, 6.5), asphyxia (RR = 8.5, 99% CI: 5.7, 11.3), respiratory distress syndrome (RR = 6.5, 99% CI: 5.9, 7.1), neonatal intensive care unit admission (RR = 3.4, 99% CI: 3.2, 3.6), longer intensive care length of stay (incidence rate ratio = 2.0, 99% CI: 1.9, 2.2), stillbirth (RR = 6.3, 99% CI: 4.7, 7.9), and neonatal mortality (RR = 7.6, 99% CI: 5.2, 10.1). In sensitivity analyses, there was a direct effect of abruption associated with increased neonatal risks. These findings expand our knowledge of the association between abruption and perinatal and neonatal outcomes. Copyright (c) The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
English
*Abruptio Placentae/ep [Epidemiology]
*Infant, Newborn, Diseases/ep [Epidemiology]
*Pregnancy Outcome/ep [Epidemiology]
Adult
Apnea/ep [Epidemiology]
Asphyxia Neonatorum/ep [Epidemiology]
Comorbidity
Female
Health Behavior
Humans
Infant
Infant Mortality
Infant, Newborn
Intensive Care Units, Neonatal/sn [Statistics & Numerical Data]
Length of Stay
Pregnancy
Resuscitation/sn [Statistics & Numerical Data]
Retrospective Studies
Socioeconomic Factors
United States/ep [Epidemiology]
MedStar Washington Hospital Center
Obstetrics and Gynecology/Maternal-Fetal Medicine
Journal Article
Multicenter Study
Observational Study
Downes, Katheryne L
Grantz, Katherine L
Downes KL, Grantz KL, Shenassa ED
https://dx.doi.org/10.1093/aje/kwx202
https://dx.doi.org/10.1093/aje/kwx202
ART
Article
0
0
0
0
Article
authcat
authcat
2018-01-18
0
28595292
28595292
2018-01-18
2018-01-18
ART
3033
3033