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Retained placenta is associated with pre-eclampsia, stillbirth, giving birth to a small-for-gestational-age infant, and spontaneous preterm birth: a national register-based study
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2014 (English)In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 121, no 12, 1462-1470 p.Article in journal (Refereed) Published
Abstract [en]

ObjectiveTo evaluate whether defective placentation disorders, i.e. pre-eclampsia, stillbirth, small for gestational age (SGA), and spontaneous preterm birth, are associated with risk of retained placenta. DesignPopulation-based cohort study. SettingSweden. PopulationPrimiparous women in Sweden with singleton vaginal deliveries between 1997 and 2009 at 32-41weeks of gestation (n=386607), without placental abruption or infants with congenital malformations. MethodsRisks were calculated as odds ratios (ORs) by unconditional logistic regression with 95% confidence intervals (95%CIs) after adjustments for maternal, delivery, and infant characteristics. Main outcome measureRetained placenta, defined by the presence of both a diagnostic code (of retained placenta) and a procedure code (for the manual removal of the placenta). ResultsThe overall rate of retained placenta was 2.17%. The risk of retained placenta was increased for women with pre-eclampsia (adjusted OR, aOR, 1.37, 95%CI 1.21-1.54), stillbirth (aOR1.71, 95%CI 1.28-2.29), SGA birth (aOR1.47, 95%CI 1.28-1.70), and spontaneous preterm birth (32-34weeks of gestation, aOR2.35, 95%CI 1.97-2.81; 35-36weeks of gestation, aOR1.55, 95%CI 1.37-1.75). The risk was further increased for women with preterm pre-eclampsia (aOR1.69, 95%CI 1.25-2.28) and preterm SGA birth (aOR2.19, 95%CI 1.42-3.38). There was no association between preterm stillbirth (aOR1.10, 95%CI 0.63-1.92) and retained placenta, but the exposed group comprised only 15 cases. ConclusionsDefective placentation disorders are associated with an increased risk of retained placenta. Whether these relationships indicate a common pathophysiology remains to be investigated.

Place, publisher, year, edition, pages
2014. Vol. 121, no 12, 1462-1470 p.
Keyword [en]
Postpartum haemorrhage, pre-eclampsia, preterm birth, retained placenta, small for gestational age, stillbirth
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:uu:diva-238410DOI: 10.1111/1471-0528.12752ISI: 000344372600003PubMedID: 24703089OAI: oai:DiVA.org:uu-238410DiVA: diva2:773103
Available from: 2014-12-18 Created: 2014-12-12 Last updated: 2017-12-05Bibliographically approved

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Wikström, Anna-Karin

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