Alcohol Consumption During Pregnancy and Risk of Placental Abruption and Placenta Previa

Muktar H. Aliyu; O'Neil Lynch; Philip N. Nana; Amina P. Alio; Roneé E. Wilson; Phillip J. Marty; Roger Zoorob; Hamisu M. Salihu

Disclosures

Matern Child Health J. 2011;15(5):670-676. 

In This Article

Abstract and Introduction

Abstract

The purpose of this study was to examine the association between prenatal alcohol consumption and the occurrence of placental abruption and placenta previa in a population-based sample. We used linked birth data files to conduct a retrospective cohort study of singleton deliveries in the state of Missouri during the period 1989 through 2005 (n = 1,221,310). The main outcomes of interest were placenta previa, placental abruption and a composite outcome defined as the occurrence of either or both lesions. Multivariate logistic regression was used to generate adjusted odd ratios, with non-drinking mothers as the referent category. Women who consumed alcohol during pregnancy had a 33% greater likelihood for placental abruption during pregnancy (adjusted odds ratio (OR), 95% confidence interval (CI) = 1.33 [1.16–1.54]). No association was observed between prenatal alcohol use and the risk of placenta previa. Alcohol consumption in pregnancy was positively related to the occurrence of either or both placental conditions (adjusted OR [95% CI] = 1.29 [1.14–1.45]). Mothers who consumed alcohol during pregnancy were at elevated risk of experiencing placental abruption, but not placenta previa. Our findings underscore the need for screening and behavioral counseling interventions to combat alcohol use by pregnant women and women of childbearing age.

Introduction

Maternal alcohol use during pregnancy is a leading preventable cause of fetal malformations, neurodevelopmental abnormalities and perinatal mortality.[1–3] One of the pathways by which alcohol is postulated to exert its inhibitory effects on fetal development is via impaired placentation.[4] The two important placental pathologies include placenta previa and placental abruption, both of which are precursors of perinatal mortality and morbidity. Placental abruption accounts for up to a third of all perinatal deaths,[5,6] mostly due to its detrimental effects on length of gestation and fetal growth.[7,8] Similarly, placenta previa is a major contributor to fetal growth restriction, preterm delivery and perinatal mortality.[9,10]

There is lack of consensus regarding the association between maternal alcohol use and placental abruption. Whereas some published reports suggest a positive association,[11–14] others do not.[15] In the case of placenta previa, a lack of association with maternal alcohol use has been the usual finding.[10,16] Few studies have analyzed the association between prenatal alcohol use and placental abruption and placenta previa together within the same cohort. These two placental pathologies are believed to have a shared etiology,[14] as mothers with a prior history of placental abruption have an increased predisposition to developing placenta previa in subsequent pregnancies,[17] and vice versa.[18,19] In consideration of this common origin theory, we set out to examine the association between prenatal alcohol consumption and the occurrence of placental abruption and placenta previa among a large representative sample of singleton births to mothers in the state of Missouri during the period 1989 through 2005.

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