Page 79 - JCTR-11-3

Journal of Clinical and
Translational Research Outcomes of placenta previa with APH

2.3. Perinatal outcomes of women having posterior placental placement was

The outcomes for mothers and newborns in both APH and significantly higher in the non-APH group (65.2%)
non-APH groups were compared. Maternal pregnancy compared to the APH group (34.4%). Though not
outcome variables included preterm delivery, placental statistically significant, a higher percentage of women in
abruption, cesarean hysterectomy, emergency cesarean the APH group were graduates (57.6%) compared to the
section, bladder damage, postpartum hemorrhage, and non-APH group (34.8%). The same is depicted in Table 2.
postoperative admissions to the intensive care units (ICUs). 3.1. Maternal outcomes
A composite unfavorable pregnancy outcome was defined
as the existence of one or more of these complications. More than half of the women in the APH group (57.6%)
had undergone emergency cesarean sections compared to
Neonatal complications were assessed using variables 4.3% in the non-APH group (OR = 29.86 [248.64 – 3.59],
such as neonatal death, preterm birth, admission to p<0.0001). Women with APH delivered at a significantly
the neonatal ICU, Apgar score at 5 min after birth, earlier gestational age than those without APH (35.5 ± 2.3
intraventricular hemorrhage, respiratory distress versus 37.5 ± 1.0, OR = 0.35 [0.65 – 0.19], p<0.0001),
syndrome, and infection. A living newborn that passes resulting in a significantly higher occurrence rate of
away within 28 days of delivery is referred to as a neonatal preterm delivery among women with APH compared
death. The composite unfavorable neonatal outcome to their non-APH counterparts (60.6% versus 4.3%,
included one or more of the abovementioned issues. 12 OR = 13.33 [54.77 – 3.25], p<0.0001). Our results in Table 3
also showed that APH instigated cesarean hysterectomy
2.4. Statistical analysis
in over 10% of the women, in contrast to 0 in women
Statistical analysis was performed using SPSS version 27 without APH.
(IBM Corporation, USA). The normality of the data was
assessed by using various statistical tests, including the 3.2. Neonatal outcomes
Shapiro–Wilk test. The Mann–Whitney U test was used Babies born to patients with APH had significantly
to compare the continuous variables. Pearson Chi-square lower birth weights (2570 ± 531.8 versus 2945.5 ± 444.8,
test was used to compare categorical variables. The odds OR = 0.998 [1.00 – 0.997], p=0.002) and were mostly
ratios (OR) for the categorical variables were calculated preterm (66.7% vs. 8.7%, OR = 21.00 [106.22 – 4.15],
using the Pearson Chi-square test, and univariate logistic p<0.0001), compared to those born to non-APH patients.
regression was utilized to analyze ordinal and continuous There was also a significantly increased incidence of
variables. Lastly, independent risk factors were identified neonatal ICU admission (24.2% versus 4.3%, OR = 7.04
using multivariate logistic regression. The threshold was [60.82 – 0.82], p=0.046) and respiratory distress syndrome
set at p<0.05. in the APH group (27.3% vs. 4.3%, OR = 8.25 [70.50 – 0.97],
p=0.028). Neonatal outcomes with 5% higher frequency in
3. Results the APH group than the non-APH group include neonatal
Women in the APH group exhibited significantly higher death, small-for-gestational-age, Apgar score at 5 min <7,
maternal age than those in the non-APH group (30.6 ± and sepsis. The same is shown in Table 4 below.
2.7 vs. 28.4 ± 4.1, OR = 1.221 [1.45 – 1.03], p=0.03). The Multivariate logistic regression analysis was conducted
type of PP was also significantly different between the two for all variables that were significant in the univariate
groups (p=0.03), with complete PP present in 27.3% of analysis, including age, gestational age at delivery,
women with APH but in only 4.3% of those without APH. delivery method, type of PP, estimated intraoperative
APH was correlated with markedly increased blood loss blood loss, intraoperative blood transfusion, birth weight,
(487.2 ± 213.6 vs. 253.5 ± 142.3, OR = 1.01 [1.01 – 1.00], hemoglogin after delivery, preterm delivery, emergency
p<0.0001) and greater demand for intraoperative blood cesarean section, preterm birth, neonatal ICU admission,
product transfusion (348.5 ± 318.3 versus 23.8 ± 109.1, and respiratory distress syndrome. However, none of the
OR = 1.01 [1.01 – 1.00], p<0.0001). Women with APH risk factors turned out to be significant in the analysis.
also had significantly lower hemoglobin after delivery than
women without APH (10.2 ± 1.1 vs. 10.9 ± 0.87, OR = 0.48 4. Discussion
[0.88 – 0.26], p=0.01). The same is depicted in Table 1. This study is a distinctive case–control retrospective study

While there was no statistically significant difference conducted at a tertiary care hospital in Karachi, Pakistan.
in placental location, the most common position in the The study includes a sample of 50 pregnant women with
APH group was anterior implantation (50% in the APH PP, comprising both individuals with and without APH.
group versus 42.3% in non-APH group). The proportion APH with an underlying cause of PP occurs due to the

Volume 11 Issue 3 (2025) 73 doi: 10.36922/jctr.25.00002