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Risk Factors for Placenta Accreta: A Large Prospective Cohort
Open accessAbstract
OBJECTIVE: Placenta previa and prior cesarean delivery are known risk factors for placenta accreta. However, other risk factors have not been identified. Our objective was to examine risk factors for accreta using data collected prospectively in a large multicenter cohort. STUDY DESIGN: Secondary analysis of women with accreta compared to those without accreta in a large multicenter cesarean delivery cohort. Potential accreta risk factors were examined by univariate and multivariate analyses. RESULTS: In this study, 196 of 73,257 (0.27%) cesarean deliveries were complicated by accreta. As expected, women with increasing numbers of prior cesareans were more likely to have an accreta (p < 0.001), as were women with previa (adjusted odds ratio [OR], 34.9; 95% confidence interval [CI], 22.4-54.3). We also considered only patients with previa and examined the following variables: maternal demographics, prior cesareans, interval between deliveries, parity, body mass index, tobacco use, and coexisting hypertension or diabetes. In this model, patients with previa and two or three prior cesarean deliveries had an adjusted OR for accreta of 4.9 (95% CI, 1.7-14.3) or 7.7 (95% CI, 2.4-24.9), respectively. However, no other variables were significantly associated with accreta. CONCLUSION: Patients with previa have increased risk for accreta that increases with the number of prior cesarean deliveries. However, no other maternal characteristics were associated with accreta.
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“In a 2015 observational study in Sweden and Norway, researchers reported that 70% of PAS cases were not diagnosed antepartum.”
From Machine Learning in Maternity: Early Diagnosis of Placenta Accreta Spectrum (2026) · cites this paper as [13]
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“Similarly, a 2014 study in Utah, United States, discovered that up to one-third of cases are not diagnosed during antepartum [12,13].”
From Machine Learning in Maternity: Early Diagnosis of Placenta Accreta Spectrum (2026) · cites this paper as [13]
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Prabowo, H. A., Anggraini, N. W. P., Anggraeni, A., & Setyawan, S. (2025) · Majalah Obstetri & Ginekologi · doi:10.20473/mog.v33i12025.37-43
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Metadata
- Authors
- Eller, A., Bardsley, T., Greene, T., Varner, M., Silver, R., & Bowman, Z.
- Affiliations
- Intermountain Healthcare (US)
- University of Utah (US)
- Corresponding author
- Bowman, Zachary
- Venue
- American Journal of Perinatology
- Publisher
- Georg Thieme Verlag KG
- Published
- 2013-12-12
- Volume
- 31
- Issue
- 09
- Pages
- 799-804
- ISSN
- 0735-1631 (ISSN-L)
- 1098-8785
- OpenAlex
- W2327089839
- Cited by
- 224
- References
- 27
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 35 · 2023: 25 · 2022: 37 · 2021: 25 · 2020: 19 · 2019: 13 · 2018: 19 · 2017: 10 · 2016: 7 · 2015: 7 · 2014: 2
- FWCI
- 4.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Perinatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Hematology › Blood transfusion and management
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- placenta accreta, placenta previa, previous cesarean section, risk factors, cesarean section complications, parity, maternal obesity, tobacco use, hypertension, diabetes mellitus
- MeSH terms
- Adult, Cesarean Section, Female, Humans, Placenta Accreta, Placenta Previa, Pregnancy, Prospective Studies, Risk Factors, United States, Young Adult
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