Association between congenital uterine anomalies and placenta accreta spectrum
Objective: To evaluate the association between congenital uterine anomalies (CUAs) and placenta accreta spectrum (PAS) in a large, nationally representative sample. Design: Cross-sectional, observational study using the US National Inpatient Sample from 2017 to 2021. Logistic regression models were...
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Elsevier
2025-03-01
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| Series: | F&S Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S266633412500008X |
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| author | Savvy Benipal, M.D. Matthew Givens, M.D. Amanda A. Allshouse, M.S. Michelle Debbink, M.D., Ph.D. Krista Childress, M.D. Joseph Letourneau, M.D. Robert M. Silver, M.D. Brett D. Einerson, M.D., M.P.H. |
| author_facet | Savvy Benipal, M.D. Matthew Givens, M.D. Amanda A. Allshouse, M.S. Michelle Debbink, M.D., Ph.D. Krista Childress, M.D. Joseph Letourneau, M.D. Robert M. Silver, M.D. Brett D. Einerson, M.D., M.P.H. |
| author_sort | Savvy Benipal, M.D. |
| collection | DOAJ |
| description | Objective: To evaluate the association between congenital uterine anomalies (CUAs) and placenta accreta spectrum (PAS) in a large, nationally representative sample. Design: Cross-sectional, observational study using the US National Inpatient Sample from 2017 to 2021. Logistic regression models were constructed to evaluate associations between the exposure and the outcome. Predetermined confounding variables included age, history of a cesarean delivery, and placenta previa. A sensitivity analysis was performed including only patients with a code for placenta accreta spectrum who also underwent hysterectomy. Data were weighted according to National Inpatient Sample complex sampling weights to account for year-to-year variation and to extrapolate estimates to the US population. Subjects: Pregnant patients at ≥20 weeks’ gestation with International Classification of Disease codes for congenital uterine anomalies or PAS. Exposure: Code for at least 1 of the CUAs. Main Outcome Measures: Code for at least 1 of the types of PAS during delivery hospitalization. Results: The study cohort included 17,594,765 (or 3,518,955 unweighted) individuals. CUAs were present in 78,809 (0.45%, 15,259 unweighted) individuals. PAS was more frequent in patients with CUA than in those without (0.42% vs. 0.12%), with a weighted odds ratio (OR) of 3.36 (95% confidence interval [CI], 2.62–4.32; unweighted OR, 3.37 [95% CI, 2.63–4.31]). When controlling for age, prior cesarean, and placenta previa, the odds of having PAS was higher in those with a CUA than in those without (weighted adjusted OR [aOR], 2.46 [95% CI, 1.87–3.17]; unweighted aOR, 2.44 [95% CI, 1.88–3.16]). In the sensitivity analysis including only individuals with PAS who underwent a hysterectomy, CUA continued to be associated with PAS (weighted aOR, 2.26 [95% CI, 1.52–3.36]; unweighted aOR, 2.26 [95% CI, 1.55–3.31]). Conclusion: In this population-based study, CUAs were associated with an increased odds of PAS. Patients with CUA should have careful screening for PAS at the time of routine obstetric ultrasound. |
| format | Article |
| id | doaj-art-c6734f4dcb96424aaba51a53ad5bfbd2 |
| institution | Kabale University |
| issn | 2666-3341 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | F&S Reports |
| spelling | doaj-art-c6734f4dcb96424aaba51a53ad5bfbd22025-08-20T03:42:52ZengElsevierF&S Reports2666-33412025-03-0161677210.1016/j.xfre.2025.01.006Association between congenital uterine anomalies and placenta accreta spectrumSavvy Benipal, M.D.0Matthew Givens, M.D.1Amanda A. Allshouse, M.S.2Michelle Debbink, M.D., Ph.D.3Krista Childress, M.D.4Joseph Letourneau, M.D.5Robert M. Silver, M.D.6Brett D. Einerson, M.D., M.P.H.7Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Intermountain Health, Salt Lake City, UtahDepartment of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Intermountain Health, Salt Lake City, UtahDepartment of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, UtahDepartment of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Intermountain Health, Salt Lake City, UtahDepartment of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah; Department of Obstetrics and Gynecology, Division of Pediatric and Adolescent Gynecology Primary Children’s Hospital, Salt Lake City, UtahDepartment of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, UtahDepartment of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, UtahDepartment of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Intermountain Health, Salt Lake City, Utah; Correspondence: Brett D. Einerson, M.D., M.P.H., Department of Obstetrics and Gynecology, University of Utah Health, 30 Mario Capecchi Dr, Room 5S158, Salt Lake City, Utah 84112.Objective: To evaluate the association between congenital uterine anomalies (CUAs) and placenta accreta spectrum (PAS) in a large, nationally representative sample. Design: Cross-sectional, observational study using the US National Inpatient Sample from 2017 to 2021. Logistic regression models were constructed to evaluate associations between the exposure and the outcome. Predetermined confounding variables included age, history of a cesarean delivery, and placenta previa. A sensitivity analysis was performed including only patients with a code for placenta accreta spectrum who also underwent hysterectomy. Data were weighted according to National Inpatient Sample complex sampling weights to account for year-to-year variation and to extrapolate estimates to the US population. Subjects: Pregnant patients at ≥20 weeks’ gestation with International Classification of Disease codes for congenital uterine anomalies or PAS. Exposure: Code for at least 1 of the CUAs. Main Outcome Measures: Code for at least 1 of the types of PAS during delivery hospitalization. Results: The study cohort included 17,594,765 (or 3,518,955 unweighted) individuals. CUAs were present in 78,809 (0.45%, 15,259 unweighted) individuals. PAS was more frequent in patients with CUA than in those without (0.42% vs. 0.12%), with a weighted odds ratio (OR) of 3.36 (95% confidence interval [CI], 2.62–4.32; unweighted OR, 3.37 [95% CI, 2.63–4.31]). When controlling for age, prior cesarean, and placenta previa, the odds of having PAS was higher in those with a CUA than in those without (weighted adjusted OR [aOR], 2.46 [95% CI, 1.87–3.17]; unweighted aOR, 2.44 [95% CI, 1.88–3.16]). In the sensitivity analysis including only individuals with PAS who underwent a hysterectomy, CUA continued to be associated with PAS (weighted aOR, 2.26 [95% CI, 1.52–3.36]; unweighted aOR, 2.26 [95% CI, 1.55–3.31]). Conclusion: In this population-based study, CUAs were associated with an increased odds of PAS. Patients with CUA should have careful screening for PAS at the time of routine obstetric ultrasound.http://www.sciencedirect.com/science/article/pii/S266633412500008XUterine anomaliesplacentaepidemiologynational inpatient sample |
| spellingShingle | Savvy Benipal, M.D. Matthew Givens, M.D. Amanda A. Allshouse, M.S. Michelle Debbink, M.D., Ph.D. Krista Childress, M.D. Joseph Letourneau, M.D. Robert M. Silver, M.D. Brett D. Einerson, M.D., M.P.H. Association between congenital uterine anomalies and placenta accreta spectrum F&S Reports Uterine anomalies placenta epidemiology national inpatient sample |
| title | Association between congenital uterine anomalies and placenta accreta spectrum |
| title_full | Association between congenital uterine anomalies and placenta accreta spectrum |
| title_fullStr | Association between congenital uterine anomalies and placenta accreta spectrum |
| title_full_unstemmed | Association between congenital uterine anomalies and placenta accreta spectrum |
| title_short | Association between congenital uterine anomalies and placenta accreta spectrum |
| title_sort | association between congenital uterine anomalies and placenta accreta spectrum |
| topic | Uterine anomalies placenta epidemiology national inpatient sample |
| url | http://www.sciencedirect.com/science/article/pii/S266633412500008X |
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