Clinical Analysis of Factors Influencing the Development of Placenta Praevia and Perinatal Outcomes in First-Time Pregnant Patients.

OBJECTIVE: To analyze the risk factors associated with the development of placenta praevia (PP) in first-time pregnant patients and to observe the perinatal clinical outcomes of patients.

METHODS: The clinical data of 112 pregnant women with PP (PP group) and 224 pregnant women with normal placental position (general group) who delivered in our hospital from August 2016 to August 2021 were retrospectively analyzed. Baseline demographic data such as age, gestational week, uterine history, assisted reproductive technology use, pregnancy comorbidities, pre-pregnancy body mass index (BMI), smoking, alcohol consumption, placental position, educational level, work were collected from both groups, and logistic regression models were used to analyze the factors influencing the occurrence of PP in patients with first pregnancy. Perinatal outcomes such as implementation of hemostatic treatment (uterine balloon compression, arterial ligation, and B-Lynch suture), maternal postpartum related indicators (amount of postpartum bleeding, incidence of postpartum hemorrhage, blood transfusion rate, blood transfusion volume, and length of hospital stay), and neonatal condition (birth weight, Apgar score at 1 and 5 min after birth) were counted and compared between the two groups.

RESULTS: Histories of endometriosis, use of assisted reproductive technology, and smoking or secondhand smoke inhalation were all high risk factors for PP in patients with first pregnancies, and the proportion of maternal and neonatal adverse outcomes was significantly higher in the PP group than in the general group ( P < 0.05).

CONCLUSION: Histories of endometriosis, smoking (secondhand smoke), and use of assisted reproductive technologies are independent risk factors for PP in patients with first pregnancies, which can increase the risk of labor and death of the newborn.