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

Authors

  • Gali Pariente,

    1. Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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  • Ilana Shoham-Vardi,

    1. Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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  • Roy Kessous,

    1. Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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  • Michael Sherf,

    1. Soroka University Medical Center, Clalit Health Services (Southern District), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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  • Eyal Sheiner

    Corresponding author
    1. Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
    • Correspondence:

      Eyal Sheiner, Department of Obstetrics and Gynecology, Soroka University Medical Center, POB 151, Beer-Sheva 84101, Israel.

      E-mail: sheiner@bgu.ac.il

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  • The authors report no conflict of interest.
  • Abstract presented at the SMFM 2013 Annual Meeting, San-Francisco, CA, Control ID: 1470304.

Abstract

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.

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