Objective
This study was undertaken to determine whether the rate of abnormal placentation is
increasing in conjunction with the cesarean rate and to evaluate incidence, risk factors,
and outcomes.
Study design
Cases from 1982-2002 were identified by histopathologic or strong clinical criteria.
Risk factors were assessed in a matched case-control study, and analyzed using conditional
logistic regression models.
Results
There were 64,359 deliveries, with cesarean rates increasing from 12.5% (1982) to
23.5% (2002). The overall incidence of placenta accreta was 1 in 533. Significant
risk factors for placenta accreta in our final analysis included advancing maternal
age (odds ratio [OR] 1.13, 95% CI 1.089-1.194, P < .0001), 2 or more cesarean deliveries (OR 8.6, 95% CI 3.536-21.078, P < .0001), and previa (OR 51.4, 95% CI: 10.646-248.390, P < .0001).
Conclusion
The rate of placenta accreta increased in conjunction with cesarean deliveries; the
most important risk factors were previous cesarean delivery, previa, and advanced
maternal age.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Obstetrics & GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Births: final data for 2002.Natl Vital Stat Rep. 2003; 52: 1-114
- Placenta previa/accreta and prior cesarean section.Obstet Gynecol. 1985; 66: 89-92
- Cesarean: changing the trends.Obstet Gynecol. 1991; 77: 195-200
- Placenta accreta: changing clinical aspects and outcome.Obstet Gynecol. 1980; 56: 31-34
- Clinical risk factors for placenta previa-placenta accreta.Am J Obstet Gynecol. 1997; 177: 210-214
- Risk factors for placenta accreta.Obstet Gynecol. 1999; 93: 545-550
- Placenta accreta: mild cases diagnosed by placental examination.Int J Gynecol Pathol. 1996; 151: 28-33
- Placenta accreta, 1945-1969.Obstet Gynecol Surv. 1972; 27: 475-490
- A study of placenta accreta.Surg Gynecol Obstet. 1937; 64: 178-200
- When can odds ratio mislead?.BMJ. 1998; 316: 989-991
Article info
Publication history
Accepted:
December 20,
2004
Received in revised form:
December 4,
2004
Received:
August 31,
2004
Footnotes
Poster presentation at 24th Annual SMFM meeting, New Orleans, La, February 2003.
Reprints are not available from the authors.
Identification
Copyright
© 2005 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
