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.
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.