Placental abruption in each hypertensive disorders of pregnancy phenotype: a retrospective cohort study using a national inpatient database in Japan

被引:10
作者
Naruse, Katsuhiko [1 ]
Shigemi, Daisuke [2 ]
Hashiguchi, Mikio [3 ]
Imamura, Masatoshi [4 ]
Yasunaga, Hideo [2 ]
Arai, Takanari [5 ]
机构
[1] Nara Med Univ, Dept Obstet & Gynecol, Kashihara, Nara, Japan
[2] Univ Tokyo, Sch Publ Hlth, Dept Clin Epidemiol & Hlth Econ, Tokyo, Japan
[3] Okinawa Prefectural Chubu Hosp, Dept Obstet & Gynecol, Uruma, Okinawa, Japan
[4] Ikoma City Hosp, Nara, Japan
[5] Keiju Med Ctr, Dept Obstet & Gynecol, Nanao, Ishikawa, Japan
关键词
Chronic Hypertension; Gestational Hypertension; Japan; Placental Abruption; Preeclampsia; PREECLAMPSIA; OUTCOMES; ASSOCIATION; MANAGEMENT; RISK;
D O I
10.1038/s41440-020-00537-6
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
We designed a retrospective cohort study using the Diagnosis Procedure Combination database, a national inpatient database for acute-care inpatients in Japan, to examine whether recent global diagnostic criteria for preeclampsia, phenotypes of hypertensive disorders of pregnancy (HDP) and features of the disease are useful as predictors of placental abruption and whether other risk factors are associated with the onset of placental abruption. A total of 85,858 hospitalized patients with a diagnosis of HDP who gave birth during hospitalization between July 2010 and March 2018 were included in this study. We examined the associations between the occurrence of placental abruption after hospitalization and several factors, including gestational age (GA) at placental abruption onset, HDP subtypes, GA on admission, maternal age, body mass index, smoking, multiple pregnancy, prelabor rupture of membranes, diabetes mellitus, emergency admission by ambulance, and consciousness, using a multivariate logistic regression analysis. Placental abruption occurred in 541 patients (0.63%) after hospital admission, and the occurrence increased acutely after 32 weeks GA. A decrease in abruption was significantly associated with maternal BMI on admission (>= 30 kg/m(2); odds ratio [OR], 0.54; 95% confidence interval [CI], 0.41-0.70) and multiple pregnancy (OR, 0.29; 95% CI, 0.18-0.46). An increase in abruption was associated with earlier GA on admission (<34 weeks' GA; OR, 3.77; 95% CI, 3.13-4.53) and emergency admission by ambulance (OR, 1.34; 95% CI, 1.09-1.65). Individual features of severe PE showed no significant associations with the occurrence of abruption. In conclusion, HDP at an earlier GA was suggested to be a risk factor for placental abruption, and we recommend hospitalization and careful management of such patients to improve their prognosis.
引用
收藏
页码:232 / 238
页数:7
相关论文
共 23 条
[1]   The impact of pre-pregnancy body mass index and gestational weight gain on placental abruption risk: a systematic review and meta-analysis [J].
Adane, Akilew A. ;
Shepherd, Carrington C. J. ;
Lim, Faye J. ;
White, Scott W. ;
Farrant, Brad M. ;
Bailey, Helen D. .
ARCHIVES OF GYNECOLOGY AND OBSTETRICS, 2019, 300 (05) :1201-1210
[2]   Severe placental abruption: clinical definition and associations with maternal complications [J].
Ananth, Cande V. ;
Lavery, Jessica A. ;
Vintzileos, Anthony M. ;
Skupski, Daniel W. ;
Varner, Michael ;
Saade, George ;
Biggio, Joseph ;
Williams, Michelle A. ;
Wapner, Ronald J. ;
Wright, Jason D. .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2016, 214 (02) :272.e1-272.e9
[3]   Placental abruption and its association with hypertension and prolonged rupture of membranes: A methodologic review and meta-analysis [J].
Ananth, CV ;
Savitz, DA ;
Williams, MA .
OBSTETRICS AND GYNECOLOGY, 1996, 88 (02) :309-318
[4]   Placental abruption among singleton and twin births in the United States: Risk factor profiles [J].
Ananth, CV ;
Smulian, JC ;
Demissie, K ;
Vintzileos, AM ;
Knuppel, RA .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 2001, 153 (08) :771-778
[5]   Hypertensive Disorders of Pregnancy ISSHP Classification, Diagnosis, and Management Recommendations for International Practice [J].
Brown, Mark A. ;
Magee, Laura A. ;
Kenny, Louise C. ;
Karumanchi, S. Ananth ;
McCarthy, Fergus P. ;
Saito, Shigeru ;
Hall, David R. ;
Warren, Charlotte E. ;
Adoyi, Gloria ;
Ishaku, Salisu .
HYPERTENSION, 2018, 72 (01) :24-43
[6]   Adverse perinatal outcomes are significantly higher in severe gestational hypertension than in mild preeclampsia [J].
Buchbinder, A ;
Sibai, BM ;
Caritis, S ;
MacPherson, C ;
Hauth, J ;
Lindheimer, MD ;
Klebanoff, M ;
VanDorsten, P ;
Landon, M ;
Paul, R ;
Miodovnik, M ;
Meis, P ;
Thurnau, G .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2002, 186 (01) :66-71
[7]   Interventionist versus expectant care for severe pre-eclampsia between 24 and 34 weeks' gestation [J].
Churchill, David ;
Duley, Lelia ;
Thornton, Jim G. ;
Moussa, Mahmoud ;
Ali, Hind S. M. ;
Walker, Kate F. .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2018, (10)
[8]   Associations of systolic blood pressure trajectories during pregnancy and risk of adverse perinatal outcomes [J].
Guo, Qianlan ;
Feng, Pei ;
Yu, Qian ;
Zhu, Wei ;
Hu, Hao ;
Chen, Xin ;
Li, Hongmei .
HYPERTENSION RESEARCH, 2020, 43 (03) :227-234
[9]   Expectant Management in Pregnancies with Severe Pre-eclampsia [J].
Haddad, Bassam ;
Sibai, Baha M. .
SEMINARS IN PERINATOLOGY, 2009, 33 (03) :143-151
[10]   Relevant Obstetric Factors for Cerebral Palsy: From the Nationwide Obstetric Compensation System in Japan [J].
Hasegawa, Junichi ;
Toyokawa, Satoshi ;
Ikenoue, Tsuyomu ;
Asano, Yuri ;
Satoh, Shoji ;
Ikeda, Tomoaki ;
Ichizuka, Kiyotake ;
Tamiya, Nanako ;
Nakai, Akihito ;
Fujimori, Keiya ;
Maeda, Tsugio ;
Masuzaki, Hideaki ;
Suzuki, Hideaki ;
Ueda, Shigeru .
PLOS ONE, 2016, 11 (01)