[Multivariate analysis of risk factors with placental abruption in preeclampsia].

OBJECTIVE: To investigate the risk factors with placental abruption in patients with preeclampsia.

METHODS: Retrospective analysis on medical documents of 219 patients treated in Peking University Third Hospital from Jan. 1994 to Dec. 2008. Patients were divided into 3 groups, including 52 cases with severe preeclampsia terminated following placental abruption, 130 cases only with severe preeclampsia and 37 cases with unexplained placental abruption without preeclampsia. One hundred and seventy-eight normal pregnancies were selected as the control group (1:2 case-control). Univariate and multivariate regression analysis were used to identify the risk factors for placental abruption in patients with preeclampsia.

RESULTS: (1) When compared with those in control group, univariate analysis showed that gravidity, parity, history of preeclampsia, second and third trimester pregnancy loss, history of autoimmune disease, chronic hypertension disease, lack of regular antenatal care, fetal growth restriction (FGR) and raises of umbilical artery Doppler resistance were risk factors associated with placental abruption. Logistic regression analysis showed that lack of a regular antenatal care (OR = 45.348, 95%CI: 17.096 - 120.288, P = 0.000), FGR (OR = 27.087, 95%CI: 5.585 - 131.363, P = 0.000) and second/third trimester pregnancy loss (OR = 16.068, 95%CI: 1.698 - 152.029, P = 0.015) were independent risk factors with placental abruption. (2) When compared with those in preeclampsia patients without placental abruption, the history of preeclampsia (OR = 3.715, 95%CI: 1.096 - 12.596, P = 0.035) and lack of a regular antenatal care (OR = 2.509, 95%CI: 1.173 - 5.370, P = 0.018) were risk factors for placental abruption in preeclampsia.

CONCLUSION: Lack of regular antenatal care, FGR, history of preeclampsia and second/third trimester pregnancy loss were risk factors associated with placental abruption in patients with preeclampsia.