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Risk factors for abnormally invasive placenta: a systematic review and meta-analysis.

Iacovelli, A; Liberati, M; Khalil, A; Timor-Trisch, I; Leombroni, M; Buca, D; Milani, M; Flacco, ME; Manzoli, L; Fanfani, F; et al. Iacovelli, A; Liberati, M; Khalil, A; Timor-Trisch, I; Leombroni, M; Buca, D; Milani, M; Flacco, ME; Manzoli, L; Fanfani, F; Calì, G; Familiari, A; Scambia, G; D'Antonio, F (2018) Risk factors for abnormally invasive placenta: a systematic review and meta-analysis. J Matern Fetal Neonatal Med, 33 (3). pp. 471-481. ISSN 1476-4954 https://doi.org/10.1080/14767058.2018.1493453
SGUL Authors: Khalil, Asma

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Abstract

Purpose of the article. To explore the strength of association between different maternal and pregnancy characteristics and the occurrence of abnormally invasive placenta (AIP). MATERIALS AND METHODS: Pubmed, Embase, CINAHL databases were searched. The risk factors for AIP explored were: obesity, age > 35 years, smoking before or during pregnancy, placenta previa, prior cesarean section (CS), placenta previa and prior CS, prior uterine surgery, abortion and uterine curettage, in vitro fertilization (IVF) pregnancy and interval between a previous CS and a subsequent pregnancy. Random-effect head-to-head meta-analyses were used to analyze the data. RESULTS: Forty-six were included in the systematic review. Maternal obesity (Odd ratio, OR: 1.4, 95% CI 1.0-1.8), advanced maternal age (OR: 3.1, 95% CI 1.4-7.0) and parity (OR: 2.5, 95% CI 1.7-3.6), but not smoking were associated with a higher risk of AIP. The presence of placenta previa in women with at least a prior CS was associated with a higher risk of AIP compared to controls, with an OR of 12.0, 95% CI 1.6-88.0. Furthermore, the risk of AIP increased with the number of prior CS (OR of 2.6, 95% CI 1.6-4.4 and 5.4, 95% CI 1.7-17.4 for two and three prior CS respectively). Finally, IVF pregnancies were associated with a high risk of AIP, with an OR of 2.8 (95% CI 1.2-6.8). CONCLUSION: A prior CS and placenta previa are among the strongest risk factors for the occurrence of AIP.

Item Type: Article
Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in The Journal of Maternal-Fetal & Neonatal Medicine on 24/6/18, available online: http://www.tandfonline.com/10.1080/14767058.2018.1493453
Keywords: Abnormally invasive placenta, cesarean section, placenta, Obstetrics & Reproductive Medicine, 1114 Paediatrics And Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: J Matern Fetal Neonatal Med
ISSN: 1476-4954
Language: eng
Dates:
DateEvent
24 June 2018Published Online
22 July 2018Published
22 June 2018Accepted
Publisher License: Publisher's own licence
PubMed ID: 29938551
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/109956
Publisher's version: https://doi.org/10.1080/14767058.2018.1493453

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