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Epidemiology

Poster Session 3

(708) Trends in placenta previa by age, race/ethnicity, and pre-pregnancy body mass index

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: To characterize recent trends in placenta previa (PP) by maternal age, race/ethnicity, and pre-pregnancy body mass index (BMI).

Study Design: Using Kaiser Permanente Southern California's electronic health records, we examined temporal trends in PP from 2009-10 through 2021-22 among singleton births at ≥20 weeks of gestation (N=507,494). Diagnosis of PP was based on the International Classification of Diseases Ninth/Tenth codes from routine clinical records of the electronic health records. We calculated the proportion of PP in the earliest (2009) versus most recent (2022) periods stratified by maternal age, race/ethnicity, and pre-pregnancy BMI. Poisson regression analysis was used to evaluate the adjusted p-values for temporal changes. Adjustments were made for maternal characteristics and behavioral factors.

Results:

The prevalence of PP was 10 per 1000 singleton pregnancies. Prevalence decreased from 11/1000 in 2009-10 to 8/1000 in 2021-22 (a relative decrease of 27.3%, p < 0.001). From 2009-10 to 2021-22, the PP rate decreased among women aged 30-34 years from 13/1000 to 8/1000, a relative decrease of 38.5% (adjusted p-value < 0.0001), and among women aged ≥35 years from 19/1000 to 14/1000, 26.3% decrease (adjusted p-value < 0.0001). Women aged < 30 years had the largest relative decrease (from 6/1000 to 3/1000; 50.0% [adjusted p-value < 0.0001]). Decreased rates of PP were observed for all race/ethnicity and BMI categories, but was largest for morbidly obese patients ( 41.7% relative reduction, adjusted p-value < 0.0001).

Conclusion:

The prevalence of PP has decreased over the past decade. PP prevalence is disproportionately higher among racial/ethnic minorities and obese women. The drivers of these disparities are unclear and need to be investigated further. Although racial/ethnic disparities in rates of PP are persistent, they could be narrowing.