THE EPIDEMIOLOGY OF PLACENTA-PREVIA IN THE UNITED-STATES, 1979 THROUGH 1987

OBJECTIVE: Placenta previa can cause serious, occasionally fatal compl ications for fetuses and mothers; however, data on its national incide nce and sociodemographic risk factors have not been available. STUDY D ESIGN: We analyzed data from the National Hospital Discharge Survey fo r the years 1979 through 1987 and from the Retrospective Maternal Mort ality Study (1979 through 1986). RESULTS: We found that placenta previ a complicated 4.8 per 1000 deliveries annually and was fatal in 0.03% of cases. Incidence rates remained stable among white women but increa sed among black and other minority women (p < 0.1). In addition, the r isk of placenta previa was higher for black and other minority women t han for white women (rate ratio 1.3, 95% confidence interval 1.0 to 1. 7), and it was higher for women greater-than-or-equal-to 35 years old than for women < 20 years old (rate ratio 4.7, 95% confidence interval 3.3 to 7.0). Women with placenta previa were at an increased risk of abruptio placentae (rate ratio 13.8), cesarean delivery (rate ratio 3. 9), fetal malpresentation (rate ratio 2.8), and postpartum hemorrhage (rate ratio 1.7). CONCLUSION: Our findings support the need for improv ed prenatal and intrapartum care to reduce the serious complications a nd deaths associated with placenta previa.