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. 2025 Jun 25:12:1588498.
doi: 10.3389/fsurg.2025.1588498. eCollection 2025.

Perinatal factors for antepartum hemorrhage in women with placenta accreta spectrum

Pengzhen Hu  1   2 , Shaoxin Ye  2   3   4   5 , Shuguang Zhou  6 , Xiaoling Guo  1   2 , Dazhi Fan  2   3   4   5
Affiliations

Perinatal factors for antepartum hemorrhage in women with placenta accreta spectrum

Pengzhen Hu et al. Front Surg. .

Abstract

Introduction: Placenta accreta spectrum with antepartum hemorrhage is closely related to maternal and fetal morbidity and mortality. It is of utmost importance to predict the possibility of antepartum hemorrhage using perinatal factors before delivery in women with placenta accreta spectrum. The aim of this study is to identify the risk factors for antepartum hemorrhage in women with placenta accreta spectrum.

Methods: This retrospective cohort study evaluated pregnant women with placenta accreta spectrum. Multivariate logistic regression was used to identify the independent variables associated with antepartum hemorrhage and a nomogram was developed to predict the possibility of antepartum hemorrhage. An Excel form computer interface was constructed to use the prediction model.

Results: This retrospective cohort study included 188 participants (74 with antepartum hemorrhage). According to multivariate logistic regression analysis, blood type O [odds ratio (OR) 2.277, confidence interval (CI) 1.220-4.250], history of miscarriage (2.178, 95% CI 1.114-4.261), and parity (1.701, 1.037-2.790) were independent risk factors for antepartum hemorrhage in women with placenta accreta spectrum.

Discussion: This results revealed that women with placenta accreta spectrum with blood type O, history of miscarriage, and multiparity may have a significant risk of experiencing antepartum hemorrhage.

Keywords: antepartum hemorrhage; nomogram; placenta accreta spectrum; placenta previa; risk factor.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Nomogram for the antepartum hemorrhage for placenta accreta spectrum women. APH, antepartum hemorrhage; PAS, placenta accreta spectrum.
Figure 2
Figure 2
Calibration curve for predicting probability of antepartum hemorrhage for placenta accreta spectrum women. APH, antepartum hemorrhage; PP, placenta accreta spectrum.
Figure 3
Figure 3
ROC curves. ROC, receiver operating characteristic; AUC, area under the ROC curve; CI, confidence interval.
Figure 4
Figure 4
Examples of the computer interface (excel form). Two examples of placenta accreta spectrum women with low (A) and high risk (B) of antepartum hemorrhage.
See this image and copyright information in PMC

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