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Abstract
OBJECTIVE
To identify risk factors for moderate or severe hypoxic-ischemic encephalopathy (HIE), or neonatal death in clinical placental abruption.
MATERIAL AND METHODS
A nested case-control study within a cohort of singleton pregnancies complicated by placental abruption with a live born infant at two academic reference centers in France, from 2006 to 2019. Cases were patients who gave birth to an infant with moderate or severe HIE or death within 28 days (HIE/death group), and controls were patients whose infant did not have any of these outcomes (no-HIE group). Independent risk factors were identified by logistic regression. Binary decision tree discriminant (CART) analysis was performed to define high-risk subgroups of HIE or death.
RESULTS
Among 152 patients, the infants of 44 (29%) had HIE or death. Out-of-hospital placental abruption and fetal bradycardia at admission were more frequent in cases than in controls: 39 (89%) vs 61 (56%), p < .01 and 24 (59%) vs 19 (18%), p < .01, respectively. In multivariate analysis, out-of-hospital placental abruption (aOR, 7.05; 95% CI, 1.94-25.66) and bradycardia at admission (aOR, 8.60; 95% CI, 2.51-29.42) were independently associated with an increased risk of HIE or death. The combination of out-of-hospital placental abruption and bradycardia was the highest risk situation associated with HIE or death (67%). The decision-to-delivery interval was 15 [12-20] minutes among cases.
CONCLUSION
Out-of-hospital placental abruption combined with bradycardia at admission was associated with a major risk of moderate or severe HIE or death. An optimal decision-to-delivery interval does not guarantee the absence of an adverse neonatal outcome.
Authors+Show Affiliations
Department of Obstetrics and Gynecology of Port Royal, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France.
Department of Obstetrics and Gynecology of Port Royal, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France.
Department of Obstetrics Gynecology and Reproductive Medicine, University Paris Est Créteil, Centre Hospitalier Inter-Communal de Créteil, Créteil, France.
Department of Obstetrics and Gynecology of Port Royal, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France; Obstetrical, Perinatal and Pediatric Epidemiology (Epopé) Research Team, Center for Epidemiology and Statistics (CRESS), INSERM U1153, Paris, France.
Department of Obstetrics and Gynecology of Port Royal, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France. Electronic address: jacques.lepercq@aphp.fr.
MeSH
Infant, NewbornInfantHumansPregnancyFemaleAbruptio PlacentaeCase-Control StudiesHypoxia-Ischemia, BrainPerinatal DeathBradycardiaPlacentaRisk FactorsParturition
Pub Type(s)
Journal Article
Language
eng
PubMed ID
36336280
Citation
Parc, Enora, et al. "Risk Factors for Hypoxic-ischemic Encephalopathy or Neonatal Death in Placental Abruption." Journal of Gynecology Obstetrics and Human Reproduction, vol. 52, no. 1, 2023, p. 102498.
Parc E, Benin A, Lecarpentier E, et al. Risk factors for hypoxic-ischemic encephalopathy or neonatal death in placental abruption. J Gynecol Obstet Hum Reprod. 2023;52(1):102498.
Parc, E., Benin, A., Lecarpentier, E., Goffinet, F., & Lepercq, J. (2023). Risk factors for hypoxic-ischemic encephalopathy or neonatal death in placental abruption. Journal of Gynecology Obstetrics and Human Reproduction, 52(1), 102498. https://doi.org/10.1016/j.jogoh.2022.102498
Parc E, et al. Risk Factors for Hypoxic-ischemic Encephalopathy or Neonatal Death in Placental Abruption. J Gynecol Obstet Hum Reprod. 2023;52(1):102498. PubMed PMID: 36336280.
* Article titles in AMA citation format should be in sentence-case
TY - JOURT1 - Risk factors for hypoxic-ischemic encephalopathy or neonatal death in placental abruption.AU - Parc,Enora,AU - Benin,Amelie,AU - Lecarpentier,Edouard,AU - Goffinet,François,AU - Lepercq,Jacques,Y1 - 2022/11/04/PY - 2022/08/16/receivedPY - 2022/10/26/revisedPY - 2022/10/27/acceptedPY - 2022/11/7/pubmedPY - 2022/11/7/medlinePY - 2022/11/6/entrezKW - Hypoxic-ischemic encephalopathyKW - Neonatal mortalityKW - Out-of-hospitalKW - Placental abruptionSP - 102498EP - 102498JF - Journal of gynecology obstetrics and human reproductionJO - J Gynecol Obstet Hum ReprodVL - 52IS - 1N2 - OBJECTIVE: To identify risk factors for moderate or severe hypoxic-ischemic encephalopathy (HIE), or neonatal death in clinical placental abruption. MATERIAL AND METHODS: A nested case-control study within a cohort of singleton pregnancies complicated by placental abruption with a live born infant at two academic reference centers in France, from 2006 to 2019. Cases were patients who gave birth to an infant with moderate or severe HIE or death within 28 days (HIE/death group), and controls were patients whose infant did not have any of these outcomes (no-HIE group). Independent risk factors were identified by logistic regression. Binary decision tree discriminant (CART) analysis was performed to define high-risk subgroups of HIE or death. RESULTS: Among 152 patients, the infants of 44 (29%) had HIE or death. Out-of-hospital placental abruption and fetal bradycardia at admission were more frequent in cases than in controls: 39 (89%) vs 61 (56%), p < .01 and 24 (59%) vs 19 (18%), p < .01, respectively. In multivariate analysis, out-of-hospital placental abruption (aOR, 7.05; 95% CI, 1.94-25.66) and bradycardia at admission (aOR, 8.60; 95% CI, 2.51-29.42) were independently associated with an increased risk of HIE or death. The combination of out-of-hospital placental abruption and bradycardia was the highest risk situation associated with HIE or death (67%). The decision-to-delivery interval was 15 [12-20] minutes among cases. CONCLUSION: Out-of-hospital placental abruption combined with bradycardia at admission was associated with a major risk of moderate or severe HIE or death. An optimal decision-to-delivery interval does not guarantee the absence of an adverse neonatal outcome. SN - 2468-7847UR - https://www.unboundmedicine.com/medline/citation/36336280/Risk_factors_for_hypoxic_ischemic_encephalopathy_or_neonatal_death_in_placental_abruption_DB - PRIMEDP - Unbound MedicineER -
Grapherence [↓1]
- Authors
- Parc E
- Benin A
- Lecarpentier E
- Goffinet F
- Lepercq J
- MESH
- Infant, Newborn
- Infant
- Humans
- Pregnancy
- Female
- Abruptio Placentae
- Case-Control Studies
- Hypoxia-Ischemia, Brain
- Perinatal Death
- Bradycardia
- Placenta
- Risk Factors
- Parturition
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