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Am J Perinatol 2017; 34(10): 0935-0957
DOI: 10.1055/s-0037-1599149
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Maternal, Labor, Delivery, and Perinatal Outcomes Associated with Placental Abruption: A Systematic Review

Katheryne L. Downes
1   Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
2   Maternal and Child Health Program, University of Maryland, College Park, Maryland
3   Department of Obstetrics and Gynecology, Center for Research in Reproduction and Women's Health, University of Pennsylvania, Philadelphia, Pennsylvania
,
Katherine L. Grantz
1   Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
,
Edmond D. Shenassa
2   Maternal and Child Health Program, University of Maryland, College Park, Maryland
4   Department of Epidemiology and Biostatistics, University of Maryland, College Park, Maryland
5   Department of Epidemiology and Biostatistics, University of Maryland, Baltimore, Maryland
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Publikationsverlauf

24. August 2016

09. Januar 2017

Publikationsdatum:
22. März 2017 (online)

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Abstract

Objective Risk factors for placental abruption have changed, but there has not been an updated systematic review investigating outcomes.

Methods We searched PubMed, EMBASE, Web of Science, SCOPUS, and CINAHL for publications from January 1, 2005 through December 31, 2016. We reviewed English-language publications reporting estimated incidence and/or risk factors for maternal, labor, delivery, and perinatal outcomes associated with abruption. We excluded case studies, conference abstracts, and studies that lacked a referent/comparison group or did not clearly characterize placental abruption.

Results A total of 123 studies were included. Abruption was associated with elevated risk of cesarean delivery, postpartum hemorrhage and transfusion, preterm birth, intrauterine growth restriction or low birth weight, perinatal mortality, and cerebral palsy. Additional maternal outcomes included relaparotomy, hysterectomy, sepsis, amniotic fluid embolism, venous thromboembolism, acute kidney injury, and maternal intensive care unit admission. Additional perinatal outcomes included acidosis, encephalopathy, severe respiratory disorders, necrotizing enterocolitis, acute kidney injury, need for resuscitation, chronic lung disease, infant death, and epilepsy.

Conclusion Few studies examined outcomes beyond the initial birth period, but there is evidence that both mother and child are at risk of additional adverse outcomes. There was also considerable variation in, or absence of, the reporting of abruption definitions.

Keywords

delivery - labor - neonatal - perinatal - placental abruption

Note

K.L. Grantz is an employee of the federal government. This research was supported in part by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.