P2C315: Placental Abruption and Intraventricular Hemorrhage in Preterm Infants: A National Cohort Study

Background: Placental abruption is a serious perinatal condition that is associated with severe adverse events including preterm delivery. It is not known if placental abruption is independently associated with intraventricular hemorrhage (IVH) in very low birth weight (VLBW) infants. Our objective is to examine the association of placental abruption with IVH in VLBW infants.

Methods: The National Inpatient Sample (NIS) datasets produced by the Health Cost and Utilization Project (HCUP) for the years 2016-2018 were used. Preterm infants < 1500g BW were included. Infants diagnosed with congenital heart diseases, congenital diaphragmatic hernia, birth asphyxia, and chromosomal disorders were excluded. The odds ratios (OR) of developing IVH and severe IVH in association with placental abruption were calculated using Chi square test. Adjusted odds ratios (aOR) of the association of IVH and severe IVH with placental abruption were calculated using logistic regression models to control for confounding variables that may independently contribute to the development of IVH such as maternal hypertension, diabetes, anemia, chorioamnionitis, placenta previa, nuchal cord, cord prolapse, Cesarean deliveries, neonatal sex, race, early or late sepsis, respiratory distress syndrome, pulmonary hypertension, or hemorrhage.

Results: 117,115 VLBW infants were identified in the dataset. Sample included 49.5% female infants, 35.6% Caucasians, 75.8% singleton pregnancies, 4.9% small for gestational age infants, and 33.0% Cesarean deliveries. Placental abruption occurred in 2.6% of the mothers of these infants. IVH occurred in 15.3% and severe IVH occurred in 4.5%. IVH occurred in 19.4% in the infants who were born to mothers with history of placental abruption versus 15.2% in infants without placental abruption, aOR 1.3 (95%CI: 1.2-1.4), p < 0.001. Severe IVH occurred in 7.1% in infants born to mothers with history of placental abruption versus 4.4% in those without placental abruption, aOR 1.6 (95%CI: 1.4-1.9), p < 0.001.

Conclusion: Placental abruption is associated with increased incidence of IVH and severe IVH in VLBW infants.