Risk factors for preterm delivery with placenta previa

Shira G. Fishman 1 , Stephen T. Chasen 1  and Bani Maheshwari 1
  • 1 Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY, USA


Aims: To identify factors associated with preterm delivery in cases of sonographically identified placenta previa.

Methods: Pregnancies with sonographic evidence of placenta previa at ≥28 weeks were identified. Demographic information, antepartum course, and delivery information were extracted from electronic medical records. Statistical analysis was performed with Fisher’s exact test, Mann-Whitney U, Spearman’s ρ (correlation), and logistic regression. Continuous data are presented as median (interquartile range).

Results: Of 113 singleton pregnancies with placenta previa, 54 (48%) delivered at term and 59 (52%) delivered preterm. Fifty-one (45%) experienced antepartum bleeding at a median gestational age of 31 weeks (29–33 weeks) with a median interval of 20 days (11–33 days) between first bleeding episode and delivery. Women with antepartum bleeding were more likely to be delivered for hemorrhage (36 of 51 vs. 8 of 62, P<0.001) and delivered emergently (40 of 51 vs. 14 of 62, P<0.001). Antepartum bleeding before 34 weeks had a positive predictive value of 88% for preterm birth and 83% for emergent delivery.

Conclusion: In pregnancies with placenta previa, antepartum bleeding is a strong predictor of preterm delivery.

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