Placental abruption during pregnancy is not associated with increased risk of cardiovascular mortality in children

1. In this cohort of singleton offspring, placental abruption during pregnancy was associated with significantly increased risk of cardiovascular mortality and nonfatal cardiovascular events from infancy onward. 

Evidence Rating Level: 2 (Good)

Cardiovascular disease (CVD) remains the leading global cause of death, and concerningly, early‑onset CVD is rising among children, adolescents, and young adults. Placental abruption, an obstetrical complication affecting about 1 in 100 pregnancies, has been linked to higher maternal cardiovascular risk, and growing evidence suggests that in‑utero exposures such as abruption, preeclampsia, and fetal growth restriction may also predispose offspring to later cardiovascular disease through genetic, epigenetic, and developmental pathways. Because the long‑term cardiovascular consequences for children born to pregnancies complicated by abruption are still unclear, this study examined whether these offspring face increased risks of early mortality and early‑onset CVD events. The exposure was placental abruption, defined as the premature separation of the placenta from the uterus. The study evaluated all-cause mortality, CVD mortality, and nonfatal cardiovascular events, grouping these events into heart disease and stroke. Among 2,949,992 singleton births, placental abruption occurred in 1% (n=28,641) of pregnancies. During a median follow-up time of 14.5 years (range 0-28; 41.9 million person-years), offspring exposed to abruption had markedly higher risks of both CVD mortality (4 [n=17] vs 1 [n=307] per 100,000 person years; adjusted hazard ratio [HR], 4.64 [95% CI, 2.75-7.86]) and nonfatal CVD events (627 [n=2,425] vs 190 [n=79,360] per 100,000 person years; HR, 2.86 [95% CI, 2.74-2.98]). These elevated risks were even more pronounced in infants under 1 year, and the associations persisted in sibling‑comparison analyses, suggesting shared familial factors did not explain them. Overall, these findings suggest that cardiovascular consequences of placental abruption extend beyond the mother, underscoring an impact that begins early and persists across the offspring’s lifespan.

Click here to read this study in Journal of the American Heart Association

Image: PD

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