Placenta accreta and maternal morbidity in the Republic of Ireland, 2005–2010

Abstract

Objective: To describe the nationwide prevalence of placenta accreta and to quantify its impact on maternal morbidity.

Methods: Using discharge data for public hospitals in Ireland, years 2005–2010, deliveries with placenta accreta were identified using ICD-10-AM code for morbidly adherent placenta and compared with deliveries without the condition. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated using logistic regression.

Results: Placenta accreta prevalence increased 34% from 2005 to 2010 (7.9/10 000 deliveries versus 10.6/10 000 deliveries). This condition was associated with a substantial increased risk of hemorrhage (aOR: 16.6, 95% CI: 13.4–20.5), hysterectomy (aOR: 950.6, 95% CI: 632.9–1427.9), procedures to reduce uterine blood flow (aOR: 72.4, 95% CI: 35.1–149.4), transfusion (aOR: 41.8, 95% CI: 33.4–52.2), anemia (aOR 15.1, 95% CI: 10.8–21.0), abdominal organ injury (aOR: 8.2, 95% CI: 5.2–13.1), bladder surgery (aOR: 38.5, 95% CI: 21.8–68.1), mechanical ventilation (aOR: 63.2, 95% CI: 28.4–140.6), intensive care unit admission (aOR: 41.3, 95% CI: 30.0–56.9), and co-existing placenta previa (aOR: 23.2, 95% CI: 16.8–31.8) as well as increased risk of cesarean section, longer hospitalization and stillbirth.

Conclusions: To our knowledge, this is the first study to use a comparison group of deliveries without placenta accreta and quantitatively illustrate with odds ratios the profound adverse health effects of this condition on the mother.

• Hospital discharge data
• Hospital In-Patient Enquiry Scheme
• ICD-10
• morbidly adherent placenta
• population-based

Acknowledgements

We appreciate the contribution of Mona Lydon-Rochelle, PhD, for conceiving the idea for this study and her input on the initial development of this project.