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    Neonatal outcomes associated with placental abruption

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    Author
    Downes, K.L.
    Shenassa, E.D.
    Grantz, K.L.
    Date
    2017
    Journal
    American Journal of Epidemiology
    Publisher
    Oxford University Press
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://www.doi.org/10.1093/aje/kwx202
    Abstract
    Placental abruption (early separation of the placenta) is associated with preterm birth and perinatal mortality, but associations with other neonatal morbidities remain understudied. We examined the association between abruption and newborn outcomes. We analyzed 223,341 singleton deliveries from the Consortiumon Safe Labor study, a retrospective, multisite, observational study (2002-2008) of electronic medical records in the United States. Adjusted relative risks, incidence rate ratios, and 99% confidence intervals were estimated. Direct effects attributable to abruption were examined by conditioning on intermediates (preterm birth and small for gestational age) with sensitivity analyses. Incidence of abruption was 1.6% (n = 3,619). Abruption was associated with an elevated risk of newborn resuscitation (relative risk (RR) = 1.5, 99% confidence interval (CI): 1.5, 1.6), apnea (RR = 5.8, 99% CI: 5.1, 6.5), asphyxia (RR = 8.5, 99% CI: 5.7, 11.3), respiratory distress syndrome (RR = 6.5, 99%CI: 5.9, 7.1), neonatal intensive care unit admission (RR = 3.4, 99%CI: 3.2, 3.6), longer intensive care length of stay (incidence rate ratio = 2.0, 99%CI: 1.9, 2.2), stillbirth (RR = 6.3, 99% CI: 4.7, 7.9), and neonatal mortality (RR = 7.6, 99% CI: 5.2, 10.1). In sensitivity analyses, there was a direct effect of abruption associated with increased neonatal risks. These findings expand our knowledge of the association between abruption and perinatal and neonatal outcomes. Copyright The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved.
    Sponsors
    The Consortium on Safe Labor was funded by the Intramural Research Program of the National Institute of Child Health and Human Development (contract HHSN267200603425C).
    Keyword
    Abruption
    Apnea
    Neonatal morbidity
    Perinatal mortality
    Respiratory distress syndrome
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85039997644&doi=10.1093%2faje%2fkwx202&partnerID=40&md5=ddb362b4983965b6bcd85844df01a875; http://hdl.handle.net/10713/9885
    ae974a485f413a2113503eed53cd6c53
    10.1093/aje/kwx202
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    UMB Open Access Articles 2017

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