Journal
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
Volume 27, Issue 1, Pages 24-29Publisher
TAYLOR & FRANCIS LTD
DOI: 10.3109/14767058.2013.799654
Keywords
Hospital discharge data; Hospital In-Patient Enquiry Scheme; ICD-10; morbidly adherent placenta; population-based
Categories
Funding
- National Perinatal Epidemiology Centre of Ireland
- Health Service Executive, Ireland
- Eunice Kennedy Shriver National Institute of Child Health and Human Development [T32 HD052462-05]
- National Institute of Nursing Research [1F31NR013092-01]
- EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT [T32HD052462] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF NURSING RESEARCH [F31NR013092] Funding Source: NIH RePORTER
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Objective: To describe the nationwide prevalence of placenta accreta and to quantify its impact on maternal morbidity. Methods: Using discharge data for public hospitals in Ireland, years 2005-2010, deliveries with placenta accreta were identified using ICD-10-AM code for morbidly adherent placenta and compared with deliveries without the condition. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated using logistic regression. Results: Placenta accreta prevalence increased 34% from 2005 to 2010 (7.9/10 000 deliveries versus 10.6/10 000 deliveries). This condition was associated with a substantial increased risk of hemorrhage (aOR: 16.6, 95% CI: 13.4-20.5), hysterectomy (aOR: 950.6, 95% CI: 632.9-1427.9), procedures to reduce uterine blood flow (aOR: 72.4, 95% CI: 35.1-149.4), transfusion (aOR: 41.8, 95% CI: 33.4-52.2), anemia (aOR 15.1, 95% CI: 10.8-21.0), abdominal organ injury (aOR: 8.2, 95% CI: 5.2-13.1), bladder surgery (aOR: 38.5, 95% CI: 21.8-68.1), mechanical ventilation (aOR: 63.2, 95% CI: 28.4-140.6), intensive care unit admission (aOR: 41.3, 95% CI: 30.0-56.9), and co-existing placenta previa (aOR: 23.2, 95% CI: 16.8-31.8) as well as increased risk of cesarean section, longer hospitalization and stillbirth. Conclusions: To our knowledge, this is the first study to use a comparison group of deliveries without placenta accreta and quantitatively illustrate with odds ratios the profound adverse health effects of this condition on the mother.
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