Placenta praevia and male sex at birth: results from a population-based study

Iron deficiency anaemia associated with increased placenta praevia and placental abruption: a retrospective case-control study

BACKGROUND/OBJECTIVES

A few studies reported association between placenta praevia (PP) and placental abruption (PA) with maternal iron deficiency anaemia (IDA), which is not an established risk factor for these conditions. This retrospective case-control study was performed to determine the relationship between IDA with PP and PA.

METHODS

Maternal characteristics, risk factors for and incidence of antepartum haemorrhage overall, and PP and PA, were compared between women with IDA only and controls without IDA or haemoglobinopathies matched for exact age and parity (four controls to each index case), who carried singleton pregnancy to ≥22 weeks and managed under our care from 1997 to 2019.

RESULTS

There were 1,176 women (0.8% of eligible women in the database) with IDA only, who exhibited slightly but significantly different maternal characteristics, and increased antepartum haemorrhage overall (3.4% versus 2.2%, p = 0.031, OR 1.522, 95% CI 1.037-2.234) and PP (1.8% versus 0.9%, p = 0.010, OR 1.953, 95% CI 1.164-3.279), but not PA (1.2% versus 1.1%, p = 0.804, OR 1.077, 95% CI 0.599-1.936). When stratified by parity status, increased PP was found in nulliparous women only. On multivariate analysis adjusting for parity, previous abortion history, overweight and obesity, short stature, other antenatal complications as a composite factor, preterm (<37) delivery, previous caesarean delivery, and infant gender, IDA was associated with PP (aOR 3.485, 95% CI 1.959-6.200) and PA (aOR 2.181, 95% CI 1.145-4.155).

CONCLUSIONS

Both PP and PA are increased in women with IDA, the prevention of which could be a means to reduce the occurrence of both PP and PA.

Association of Placenta Previa with a History of Previous Cesarian Deliveries and Indications for a Possible Role of a Genetic Component

A prior Cesaria section (C-section) is an important risk factor that leads to endometrial damage and abnormal implantation of the placenta. Our retrospective study aims to correlate the frequency of placenta previa to previous C-sections, to determine the effect of male gender in this condition and to evaluate further the maternal outcome. Seventy-six cases with placenta previa were selected out of 5200 live births. Diagnosis was confirmed by ultrasound and in the operating theater. In the 76 women examined, we found 50 cases with a history of a previous C-section (66.0%) and 49 male offspring (65.0%) (p <0.001), with a mean birth weight of 2635 ± 740 g. Of all these patients, six (8.0%) cases developed placenta percreta, seven (9.0%) were transferred to the intensive care unit (ICU), 14 (18.0%) women needed blood transfusion and eight (11.0%) underwent hysterectomy. The results of our series show a strong correlation of placenta previa to a history of previous C-sections and a predominance of male fetuses. Early recognition and proper monitoring could minimize the possibility of a poor outcome.

Untangling the most probable role for vitamin D3 in autism

Recent studies indicate an important role for vitamin D3 in autism spectrum disorder (ASD), although its mechanism is not completely understood. The most puzzling aspect of ASD is that identical twins, who share identical DNA, do not have 100% concordance rates (∼88% for identical and ∼31% for fraternal twins). These findings provide major clues into the etiology: ASD must involve an environmental factor present in the prenatal milieu that both identical twins are not always exposed to because they do not always share it (i.e., placentas). Combined with the exponential increasing rates of ASD around the world, these observations suggest a contagious disease is probably transferred to the fetus via the placenta becoming infected by a cervical virus. Vitamin D3 boosts immune responses clearing viral infections and increases serotonin and estrogen brain levels. Here we review the different roles and untangle the most probable one vitamin D3 plays in ASD.

Risk of adverse maternal and peri-natal outcome in subjects with placenta previa with previous cesarean section

The aim of this study was to compare maternal and perinatal adverse outcomes between groups of placenta previa (PP) with and without previous cesarean section (CS). A prospective study was carried out from March 2008 to August 2009 at the department of Obstetrics and Gynecology, Hera General Hospital, Makkah, Saudi Arabia. Diagnosed cases of PP with singleton pregnancy presenting with ante-partum hemorrhage (APH) in the 3rd trimester undergoing either emergency or elective CS were included. Subjects were divided into two groups, 30 with previous CS (group A) and 27 without previous CS (group B), and the risks of adverse maternal and perinatal outcomes were compared. Data were analyzed using SPSS version 16 (SPSS Inc., Chicago, IL, USA).One mother in group A died due to disseminated intravascular coagulation. The risk of post partum hemorrhage (PPH), blood transfusion and coagulopathy was higher in group A, (OR 4.8, 95% CI 1.5-15; p=0.008; OR 4.8, 95% CI 1.5-15; p=0.008; OR 9.5, 95% CI 1.2-81.6; p=0.03, respectively). Mean length of hospital stay (days±SD) in group A was significantly longer than that in group B (5.3±3.2 vs. 3.2±1.5, 95% CI 0.8-3.2; p=0.002). A higher risk of perinatal adverse outcome was found in group A, but the difference was not significant.Risk of maternal morbidity was higher than that of perinatal morbidity in Group A.