TY - JOUR
T1 - Risk factors for placenta accreta spectrum
T2 - Findings from the Japan environment and Children's study
AU - the Japan Environment and Children's Study (JECS) Group
AU - Kyozuka, Hyo
AU - Yamaguchi, Akiko
AU - Suzuki, Daisuke
AU - Fujimori, Keiya
AU - Hosoya, Mitsuaki
AU - Yasumura, Seiji
AU - Yokoyama, Tadahiko
AU - Sato, Akiko
AU - Hashimoto, Koichi
AU - Kawamoto, Toshihiro
AU - Saito, Hirohisa
AU - Kishi, Reiko
AU - Yaegashi, Nobuo
AU - Mori, Chisato
AU - Ito, Shuichi
AU - Yamagata, Zentaro
AU - Inadera, Hidekuni
AU - Kamijima, Michihiro
AU - Nakayama, Takeo
AU - Iso, Hiroyasu
AU - Shima, Masayuki
AU - Hirooka, Yasuaki
AU - Suganuma, Narufumi
AU - Kusuhara, Koichi
AU - Katoh, Takahiko
N1 - Funding Information:
The Japan Environment and Children's Study was funded by the Ministry of the Environment of Japan. The findings and conclusions of this article are solely the responsibility of the authors and do not represent the official views of the above government. The funding had no role in the design of the study, collection and analysis of data, interpretation of the result, writing the manuscript, or decision to publish. The Japan Environment and Children's Study was funded by the Ministry of the Environment Japan. The findings and conclusions of this article are solely the responsibility of the authors and do not represent the official views of the Ministry of the Environment.
Publisher Copyright:
© 2019 The Author(s).
PY - 2019/11/27
Y1 - 2019/11/27
N2 - Background: Placenta accreta spectrum (PAS) is a life-threating complication in the field of obstetrics. Sometimes we face with unexpected PAS cases which is potentially higher maternal mortality and morbidity compared with expected cases. The present study was conducted to examine the prevalence of PAS and to elucidate its risk factors using a large Japanese birth cohort study. Methods: We reviewed the results of a nationwide prospective birth cohort study in Japan, and identified 90,554 participants treated from 2011 to 2014 in 15 regional centers. Multiple regression models were created to identify the risk factors for PAS. These data were obtained from self-reported questionnaires or patient medical records. Results: This analysis consisted of 202 cases of PAS (18 with placenta previa and 184 without placenta previa) and 90,352 cases without PAS. The multiple logistic regression analysis showed that placenta previa (adjusted odds ratio [aOR]: 12.86, 95% confidence interval [CI] 7.70-21.45, P < 0.001), assisted reproductive technology-related pregnancies (aOR: 6.78, 95% CI 4.54-10.14, P < 0.001), smoking during pregnancy (aOR: 1.95, 95% CI 1.15-3.31, P = 0.013), more than two previous cesarean sections (aOR: 2.51, 95% CI 1.35-4.67, P = 0.004), and uterine anomalies (aOR: 3.97, 95% CI 1.24-12.68, P = 0.020) increased the risk of PAS. Conclusion: In general population, placenta previa, assisted reproductive technology-related pregnancy, smoking during pregnancy, repeated cesarean sections, and uterine anomalies were risk factors for PAS in the Japanese population.
AB - Background: Placenta accreta spectrum (PAS) is a life-threating complication in the field of obstetrics. Sometimes we face with unexpected PAS cases which is potentially higher maternal mortality and morbidity compared with expected cases. The present study was conducted to examine the prevalence of PAS and to elucidate its risk factors using a large Japanese birth cohort study. Methods: We reviewed the results of a nationwide prospective birth cohort study in Japan, and identified 90,554 participants treated from 2011 to 2014 in 15 regional centers. Multiple regression models were created to identify the risk factors for PAS. These data were obtained from self-reported questionnaires or patient medical records. Results: This analysis consisted of 202 cases of PAS (18 with placenta previa and 184 without placenta previa) and 90,352 cases without PAS. The multiple logistic regression analysis showed that placenta previa (adjusted odds ratio [aOR]: 12.86, 95% confidence interval [CI] 7.70-21.45, P < 0.001), assisted reproductive technology-related pregnancies (aOR: 6.78, 95% CI 4.54-10.14, P < 0.001), smoking during pregnancy (aOR: 1.95, 95% CI 1.15-3.31, P = 0.013), more than two previous cesarean sections (aOR: 2.51, 95% CI 1.35-4.67, P = 0.004), and uterine anomalies (aOR: 3.97, 95% CI 1.24-12.68, P = 0.020) increased the risk of PAS. Conclusion: In general population, placenta previa, assisted reproductive technology-related pregnancy, smoking during pregnancy, repeated cesarean sections, and uterine anomalies were risk factors for PAS in the Japanese population.
KW - Assisted reproductive technology
KW - Birth cohort study
KW - Placenta accreta spectrum
KW - Placenta previa
KW - Smoking
KW - Uterine anomaly
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U2 - 10.1186/s12884-019-2608-9
DO - 10.1186/s12884-019-2608-9
M3 - Article
C2 - 31775687
AN - SCOPUS:85075777739
VL - 19
JO - BMC Pregnancy and Childbirth
JF - BMC Pregnancy and Childbirth
SN - 1471-2393
IS - 1
M1 - 447
ER -
