Risk Factors for Placenta Praevia in the Niger Delta Region of Nigeria: A Case Control – Study
Asian Research Journal of Gynaecology and Obstetrics,
Background: Placenta praevia remains a major cause of antepartum haemorrhage contributing significantly to maternal and perinatal mortality especially in developing countries including Nigeria. This study sought to determine the risk factors for placenta praevia among parturients in Niger Delta University Teaching Hospital, Okolobiri, in the south-south region of Nigeria.
Methods: The study was a retrospective case control study comprising 62 parturients with placenta praevia (cases) and 64 parturients without placenta praevia serving as control. Using a self-designed proforma data which include sociodemographic characteristics, past obstetric and gynaecological history and history of index pregnancy was extracted from patients’ medical records. Difference between cases and controls was explored using Chi-square test of proportion, while risk factors for placenta praevia were identified using a multivariate binary logistic regression analysis. Level of significance was set at pValue < 0.05.
Results: The women with placenta praevia (33.4±4.9years) were significantly (t=4.88;p-0.001) older than women in the control group (29.3±4.67years). Parity significantly differs between the case and the control group(X2–40.64;p-0.001). Risk factors for placenta previa identified in our locality include grandmultiparity[OR=14.65,(95%CI:1.50–143.45)], age≥35years[OR = 4.96,( 95% CI:1.45–16.93)], previous caesarean section[OR=3.66(95%CI:1.13–11.81)], and history of previous abortion[OR=2.68,(95% CI 1.13 – 7.24)].
Conclusion: From this study, the risk factors for placenta praevia were grandmultiparity, maternal age ≥35 years, previous caesarean section and history of previous abortion. Caregivers should be aware of this to ensure a high index of suspicion and thereby have good knowledgeable anticipation in the management of these patients.
- Placenta praevia
- risk factors
How to Cite
Neilson JP. Antepartum haemorrhage. In: D. Keith Edmonds (ed ). Dewhurst’s Texbook of Obstetrics and Gynaecology for Postgraduates. 6th edition. Oxford: Blackwell Science (Blackwell Publishing). 1999;134 – 144.
Kwawukume SN. Antepartum haemorrhage. In: Kwawukume EY and Emuveyan EE (eds). Comprehensive Obstetrics in the Tropics. Dansoman: Asante and Hittscher Publishers. 2002;140-150.
Daftary SN, Chakravarti S. In: Manual of OBSTETRICS. Second Edition. ELSEVIER. A division of Reed Elsevier India Pvt. Ltd. 2005;231 – 240.
Navti OB, Konje JC. Bleeding in late pregnancy. In: James D, Steer PJ, Weiner CP, Gonik B(eds). High Risk Pregnancy. Management Options. 4th Edition. Philadelphia: Saunders. 2020; 1015 – 1028.
Cresswell JA, Ronsmans C, Calvert C, Filippi V. Prevalence of placenta praevia by world region: a systematic review and meta-analysis. Trop Med Int Health. June 2013;18(6):712 – 724.
Iyasu S, Saftlas AK, Rowley DL, Koonin LM, Lawson HW, Atrash HK.The epidemiology of placenta previa in the United States, 1979 through 1987. Am J Obstet Gynecol. 1993 May. 168(5):1424-9.
Kim LH, Caughey AB, Escobar G. Racial and ethnic differences in the prevalence of placenta previa. Journal of Perinatology. 2012;32:260-264.
Anderson-Bagga FM, Sze A. Pubmed Review. Placenta Previa. In: StatPearls. Treasure Island (FL): StatPearls Publishing. June27;2020-08-17
Faiz AS, Ananth CV. Etiology and risk factors for placenta previa: an overview and meta-analysis of observational studies. J Matern Fetal Neonatal Med. 2003;13(3):175-190.
Eniola AO, Bako AU, Sele-Ojeme DO. Risk factors for placenta praevia in southern Nigeria. East African Medical Journal. 2002 Oct;79(10):535-538.
Tuzovic I, Djelmis J, Ilijic M. Obstetric risk factors assoiated with placenta previa development: case-control study. Croat. Med J. 2003;44(6):728-733.
Marshall NE, FU R, Guise JM. Impact of multiple caesarean deliveries on maternal morbidity: a systematic review. Am J Obstet Gynecol 2011; Sep. 205(3):262. e 1-8.
DOI: 10. 1016/j. ajog.2011.06.035. Epub Jun 15. PMID: 22071057.
Ananth CV,Smulian JC, Vintzileos AM. The association of placenta previa with history of caesarean delivery and abortion: a metaanalysis. Am J Obstet Gynecol. 1997;177(5):1071-1078.
Klar M, Michels KB. Cesarean section and placental disorders in subsequent pregnancies—a meta-analysis. J Perinat Med. 2014;42(5):571-581.
Milosevic J, Lilic V, Tasic M, Radovic-Janosevic D, Stefanovic M, Antic V. Placental complications after a previous caesarean section. Med Pregl. 2009 May-Jun. 62(5-6):212-6.
Arian k, Amela T, Zamira S. Statistical Data About Risk Factors and Pregnancy Outcome of Placenta Previa. European Scientific Journal, Esj. 2018;14(15):27. DOI:https://doi.org/10.19044/esj.2018.v14n15p27
Shoberi F, Jenabi E. Smoking and placenta previa: a metanalysis. J Maternal Fetal Neonatal Med. 2017;30:2985.
Oppenheimer L. Society of obstetricians and gynaecologists of Canada. Diagnosis and management of placenta previa. J Obstet Gynecol Can. 2007;29:261-73.
Quant HS, Friedman AM, Wang E et al. Transabdominal ultrasonography as a screening test for second –trimester placenta previa. Obstet Gynecol. 2014;123 628-33.
Wexler P, Gottesfeld KR. Early diagnosis of placenta previa. Obstet Gynecol. 1979 Aug. 54(2):231-4.
Mcafee CHG. Placenta praevia- A Study of 174 Cases. BJOG. 1945;52(4):313-324.
Ezechi OC, Kalu BKE, Nwokoro CA, Njokanma FO, Loto OM, Okeke GC. Placenta praevia: A Study of Risk Factors, Maternal and Fetal Outcome. Trop J Obstet Gynaecol. 2004;21(2):131-134.
Shobeiri F, Jenabi E, Karami M, Karimi S Determinants of placenta previa: a case-control study. Biomedical Research and Therapy. 2017;4(6): 1411-149.
Gilliam M, Rosenberg D, Davis F. The likelihood of placenta praevia with greater number of cesaerean deliveries and higher parity. Obstet Gynecol. 2002;99(6):976-80..
Babinszky A, Kerenyi T, Torok O, Grazi V, Lapinski RH, Berkowitz RL. Perinatal 0utcome in grand and great-grandmultiparity: effects of parity on obstetric risk factors. Am J Obstet Gynaecol. 1999;181:669-74.
Mgaya AH, Massawe SN, Kidanto HL, Mgaya HN. Grand multiparity: is it still a risk in pregnancy? BMC Pregnancy Childbirth. 2013;13:241. Published online 2013 Dec 23. DOI: 10.1186/1471-2393-13-241
Hailimi S. Association of placenta praevia with multiparity and previous caesarean section. JPMI. 2011;25(2):139-142.
King LJ, Dhanya MA, Nordberg C, Paglia MJ. Maternal risk factors associated with persistent placenta praevia. Placenta. 2020;99:189. Epub 2020 Aug 6.
Downes KL, Hinkle SN, Sjaarda La, Albert PS, Grantz KL. Previous prelabour or intrapartum caesarean delivery and risk of placenta previa. Am J Obstet Gynecol. 2015;212(5):669. e1. Epub 2015 Jan 7.
Latif L, Iqbal UJ, Aftab MU. Associated risk factors of placenta previa: A Matched Case Control Study. PJMHS. 2015; 9(4):1344-1346.
Manoochehr Karami, Ensiyeh Jenabi. Placenta previa after prior abortion: a meta-analysis. Biomed Res Ther. 2017;4(7):1441-1450.
Abu-Heija A, El-Jallad F, Ziadeh S. Placenta previa: effect of age, gravidity, parity and previous caesarean section. Gynecol Obstet Invest. 1999;47:6-8.
Nkwo EC, Onoh RC, Nkwo GCE, Orakwe O. Placenta Praevia: Diagnosis and Management outcomes in a medical centre , South East Nigeria. JMSCR. 2018; 6(120);413-419.
Anzaku AS, Musa J. Placenta praevia: Incidence, Risk Factors, Maternal and Fetal Outcomes in a Nigerian Teaching Hospital. Jos J. Medicine. 2012;6(1): 42-46.
Zhang J, Savitz DA. Maternal age and placenta praevia – a case control study. Amer J Obstet Gynecol. 1993; 168:586-588.
Abstract View: 67 times
PDF Download: 33 times