Placental Abruption as a Significant Risk Factor for Long-term Cardiovascular Mortality in a Follow-up Period of More Than a Decade

BackgroundTo investigate the risk for subsequent cardiovascular events in women having placental abruption during a follow-up period of more than 10 years. MethodsA 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. ResultsDuring the study period, there were 47585 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). ConclusionPlacental abruption is a significant risk factor for long-term cardiovascular mortality in a follow-up period of more than a decade.