Poster Session 2
Category: Clinical Obstetrics
Poster Session 2
Emily B. Rosenfeld, DO (she/her/hers)
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey, United States
Amanda Tuchler, MD
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey, United States
Rachel Lee, MS
Rutgers Robert Wood Johnson Medical School
Rutgers Robert Wood Johnson Medical School, New Jersey, United States
Minxiu Shi
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey, United States
Ruchira Sharma, MD (she/her/hers)
Assistant Professor
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey, United States
Cande V. Ananth, PhD
Professor and Vice Chair for Academic Affairs, Department of Obstetrics, Gynecology, and Reproductive Sciences
Rutgers Robert Wood Johnson Medical School
Rutgers Robert Wood Johnson Medical School, New Jersey, United States
Estimates of abruption recurrence risk originate from outdated studies that may not reflect current risks due to changes in modifiable risk factors and limit the ability to counsel patients about their recurrence risk. The aim of this study is to assess the recurrence risk of patients with placental abruption using a contemporary cohort and to assess the impact of modifiable risk factors on abruption recurrence.
Study Design:
The study utilizes the Placental Abruption and Cardiovascular Event Risk (PACER) cohort, which includes all births in New Jersey from 1993 to 2020, linked with hospital discharge and mortality records. The cohort was restricted to women with two or more deliveries. Confounder-adjusted relative risks (aRR) and 95% confidence intervals (CI) were calculated using Poisson regression models to assess the risk of recurrent abruption and joint effects of modifiable risk factors.
Results:
There were 662,140 women who contributed to at least 1,324,280 deliveries within the cohort, of which 5850 (0.9%) had an abruption in the first delivery and 6287 (0.9%) had an abruption in the second delivery. Of those that had an abruption in the first pregnancy, 209 (3.6%) had recurrent abruption (aRR 3.5, 95% CI 3.4, 3.7). The highest risk of recurrent abruption was seen in those with tobacco use in both pregnancies (RR 6.2, 95% CI 5.7, 6.7), had severe preeclampsia in either pregnancy (RR 5.2, 95% CI 4.6, 5.8), pregestational diabetes in either pregnancy (RR 7.8, 95% CI 7.1, 8.6), and multiples in both pregnancies (RR 22.2, 95% CI 20.9, 23.4) (Table 1). Tobacco users who had an abruption in their first pregnancy but quit smoking before their second pregnancy reduced their risk of abruption in the second pregnancy (RR 0.6, 95% CI 0.2, 1.4) compared to persistent smokers.
Conclusion:
The overall risk of recurrent abruption is 3.6%, and eliminating modifiable risk factors can further decrease the risk in future pregnancies.