Clinical risk factors for vasculo-placental disorders: results from a prospective case-control study nested in HEMOTHEPP French cohort study - 21/11/22
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Abstract |
Objective |
Determine clinical risk factors for vasculo-placental disorders in singleton pregnancies.
Design |
Prospective case-control study nested in HEMOTHEPP French cohort.
Setting |
Women delivered between June, 2015 and January, 2019 in any maternity ward of Finistère.
Population |
Cases were women with vasculo-placental disorders (pre-eclampsia, intrauterine growth restriction (IUGR), placental abruption or stillbirth). Controls were women matched for age at delivery and parity.
Methods |
Clinical data were collected by obstetricians or midwives during antenatal care visits and delivery, and recorded by trained research assistants.
Main Outcome Measures |
Occurrence of a vasculo-placental disorder.
Results |
505 women with vasculo-placental disorder (299 pre-eclampsia, 253 IUGR, 44 placental abruptions, 11 stillbirths) and 1515 matched controls were selected out of 20,075 participants.
In multivariable analysis, four clinical parameters were associated with pre-eclampsia: obesity (Odd ratio (OR) = 3.11, 95%CI 2.11-4.58), French overseas origin (OR = 4.41, 95%CI 1.87-10.42), previous vasculo-placental disorder (OR = 5.14, 95%CI 2.72-9.70), aspirin during pregnancy (OR = 10.10, 95%CI 1.99-51.08). Three clinical parameters were associated with IUGR: auto-immune/inflammatory disorder (OR = 3.75, 95%CI 1.83-7.68), previous vasculo-placental disorder (OR = 3.63, 95%CI 2.06-6.41), smoking during pregnancy (OR = 2.66, 95%CI 1.91- 3.71). A previous venous thromboembolism (VTE) was associated with IUGR in univariable but not in multivariable analysis (OR = 3.72, 95%CI 0.82-17.00, p = 0.09).
Conclusions |
Clinical risk factors differ between IUGR and pre-eclampsia, the later, but not the former, being associated with cardiovascular risk factors.
Le texte complet de cet article est disponible en PDF.Keywords : Placental insufficiency, pre-eclampsia, intrauterine growth restriction, risk factors, venous thromboembolism
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