Maternal serum markers, characteristics and morbidly adherent placenta in women with previa

• Published in: Journal of perinatology Vol. 35; no. 8; pp. 570 - 574
• Main Authors: Lyell, D J, Faucett, A M, Baer, R J, Blumenfeld, Y J, Druzin, M L, El-Sayed, Y Y, Shaw, G M, Currier, R J, Jelliffe-Pawlowski, L L
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01-08-2015; Nature Publishing Group
• Subjects: 692/308/1892; Abdominal wall; Adolescent; Adult; alpha-Fetoproteins - analysis; Biomarkers - blood; California; Cesarean Section - statistics & numerical data; Confidence intervals; Female; Health risk assessment; Humans; Logistic Models; Medicine; Medicine & Public Health; Neural tube; original-article; Pediatric Surgery; Pediatrics; Placenta; Placenta Accreta - blood; Placenta praevia; Placenta Previa - blood; Pregnancy; Pregnancy Complications - blood; Pregnancy Trimester, First; Pregnancy Trimester, Second; Pregnancy-Associated Plasma Protein-A - analysis; Pregnant women; Prenatal Diagnosis; Statistical analysis; Young Adult; California; United States
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2015.40

Objective:
To examine associations with morbidly adherent placenta (MAP) among women with placenta previa.
Study Design:
Women with MAP (cases) and previa alone (controls) were identified from a cohort of 236 714 singleton pregnancies with both first and second trimester prenatal screening, and live birth and hospital discharge records; pregnancies with aneuploidies and neural tube or abdominal wall defects were excluded. Logistic binomial regression was used to compare cases with controls.
Result:
In all, 37 cases with MAP and 699 controls with previa alone were included. Risk for MAP was increased among multiparous women with pregnancy-associated plasma protein-A (PAPP-A) ⩾95th percentile (⩾2.63 multiple of the median (MoM); adjusted OR (aOR) 8.7, 95% confidence interval (CI) 2.8 to 27.4), maternal-serum alpha fetoprotein (MS-AFP) ⩾95th percentile (⩾1.79 MoM; aOR 2.8, 95% CI 1.0 to 8.0), and 1 and ⩾2 prior cesarean deliveries (CDs; aORs 4.4, 95% CI 1.5 to 13.6 and 18.4, 95% CI 5.9 to 57.5, respectively).
Conclusion:
Elevated PAPP-A, elevated MS-AFP and prior CDs are associated with MAP among women with previa.