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- W4240080523 abstract "Placenta accreta spectrum (PAS) is associated with catastrophic maternal outcomes. However, the pathophysiology rendering PAS is not well-defined. There has been data to suggest that in vitro fertilization (IVF) may be a risk factor for PAS. We hypothesized that IVF is an independent risk factor for PAS. A retrospective analysis of all deliveries in a prospectively collected, population-based cohort (2012-2019) was performed in a tertiary academic center. Primary outcome variable was PAS. Univariate analysis was performed on potential clinical risk factors associated with PAS and a multivariate model was designed to best fit the prediction of PAS. Since the history of previous cesarean delivery was known to act as a risk factor for both placenta previa and PAS, the interaction between ‘placenta previa’ and ‘previous cesarean delivery’ was included in the final model. Odds ratios were calculated as the exponential of beta coefficients from the multivariate regression analysis. A total of 37,422 subjects were investigated. Among those, 5427 (15%) had history of cesarean delivery, 255 (0.7%) had placenta previa in their index pregnancy, and 568 (1.5%) had IVF pregnancy. The frequency of PAS was 191 (0.5%). IVF pregnancy was an independent risk factor for PAS (adjusted odds ratio [aOR]=6.234, 95% confidence interval [CI] 2.356-16.495), as well as history of prior cesarean delivery (aOR=16.761, 95% CI 8.684-32.353) and presence of placenta previa (aOR=58.550, 95% CI 15.864-216.094). When adjusted for the number of prior cesarean deliveries, the correlation persisted for IVF (aOR=6.108 95% CI 2.396-15.569). IVF significantly increases the odds of developing PAS independent of placenta previa and history of cesarean delivery. The pathophysiology behind this relationship remains to be investigated." @default.
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- W4240080523 date "2020-01-01" @default.
- W4240080523 modified "2023-09-27" @default.
- W4240080523 title "1084: In Vitro Fertilization is an independent risk factor for placenta accreta spectrum" @default.
- W4240080523 doi "https://doi.org/10.1016/j.ajog.2019.11.1096" @default.
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