[en] INTRODUCTION: It has been suggested that women with obesity have increased risk of developing placenta accreta spectrum (PAS). It is unclear if this is independent of the increased risk of cesarean delivery seen with obesity itself. The aim of this study was to explore the association between maternal obesity and PAS, particularly severe PAS (percreta). MATERIAL AND METHODS: This is a cohort study based on cases recorded in the International Society for Placenta Accreta Spectrum (IS-PAS) database between April 2008 and May 2019. Multivariable logistic regression was used to explore the effect of maternal obesity on severity of PAS; this model was adjusted for other known risk factors including previous cesarean deliveries, maternal age, and placenta previa. The estimated rate of obesity in a hypothetical cohort with similar characteristics (previous cesarean delivery and same parity) was calculated and compared with the observed rate of obesity in the women of the PAS cohort (one sample test of proportions). RESULTS: Of the 386 included women with PAS, 227 (58.8%) had severe disease (percreta). In univariable analysis, maternal obesity initially appeared to be associated with increased odds of developing the most severe type of PAS, percreta (odds ratio [OR] 1.87; 95% CI 1.14-3.09); however, this association was lost after adjustment for other risk factors including previous cesarean delivery (OR 1.44; 95% CI 0.85-2.44). There was no difference in the observed rate of obesity and the rate estimated based on the risk of cesarean delivery from obesity alone (31.3% vs 36.8%, respectively; P = .07). CONCLUSIONS: Obesity does not seem to be an independent risk factor for PAS or severity for PAS. These findings are relevant for clinicians to provide accurate counseling to women with obesity regarding increased risks related to pregnancy.
Disciplines :
Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
Vieira, Matias C ; Department of Obstetrics and Gynaecology, Oxford University Hospitals NHS ; Department of Women and Children's Health, School of Life Course Sciences, ; Department of Obstetrics and Gynaecology, School of Medical Sciences, University
Rijken, Marcus J; Division Woman and Baby, University Medical center Utrecht, Utrecht, Netherlands. ; Julius Global Health, The Julius center for Health Sciences, University Medical
Braun, Thorsten ; Departments of Obstetrics and Division of Experimental Obstetrics, Charité
Chantraine, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR) ; Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire de
Morel, Olivier; Nancy Regional University Hospital, Université de Lorraine, Nancy, France.
Schwickert, Alexander ; Department of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member
Stefanovic, Vedran ; Department of Obstetrics and Gynecology, Fetomaternal Medical Center, Helsinki
van Beekhuizen, Heleen ; Department of Gynecological Oncology, Erasmus MC Cancer center, Rotterdam, The
Collins, Sally L; Department of Obstetrics and Gynaecology, Oxford University Hospitals NHS ; Nuffield Department of Women's and Reproductive Health, University of Oxford,
International Society for Placenta accreta spectrum, ( I S-P A S)
Language :
English
Title :
The relation between maternal obesity and placenta accreta spectrum: A multinational database study.
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