Analysis of factors influencing premature birth in cases with placenta previa complicated by placenta accreta spectrum disorders.

Objective To retrospectively analyze of factors influencing early preterm birth (EPB) and late preterm birth (LPB ) in pregnancy women with placenta previa complicated by placenta accreta spectrum disorders ( PAS ), and assess maternal and infant outcomes. Methods We included 590 cases of pregnancy women with placenta previa complicated by PAS who underwent cesarean sections at five hospitals in Wuhan and Xianning cities between January 2018 and June 2021. These patients were divided into three groups based on delivery gestational age : EPB, LPB, and term birth (TB). A multiple logistic regression model was employed to analyze the risk factors associated with EPB and LPB. Additionally, differences in early maternal and infant outcomes among these groups were examined. Results Among 590 pregnancy women with placenta previa complicated by PAS, the proportions of EPB and LPB were 9.7% and 54.4%. The use of uterine contraction inhibitors prior to cesarean section, vaginal bleeding, and previous cesarean sections history were identified as risk factors for both EPB and LPB. The proportion of severe postpartum hemorrhage was comparable between the EPB group and the LPB group ; however, the incidence of neonatal asphyxia, low birth weight infants, and the rate of newborns transferred to the Neonatal Intensive Care Unit (NICU) within 24 hours after cesarean delivery were significantly higher in the EPB group compared to the LPB group. Conclusions Placenta previa complicated by PAS predominantly leads to LPB. The history of prior cesarean sections, uterine contractions, and vaginal bleeding prior to cesarean section, are significantly associated with both EPB and LPB. During the perinatal period, efforts should be made to extend gestational weeks under close monitoring to minimize the incidence of premature births and thereby improve early maternal and infant outcomes. [ABSTRACT FROM AUTHOR]