Risk Factors for Placenta Praevia in the Niger Delta Region of Nigeria: A Case Control – Study

Abstract

Background: Placenta praevia remains a major cause of antepartum haemorrhage contributing significantly to maternal and perinatal mortality especially in developing countries including Nigeria. This study sought to determine the risk factors for placenta praevia among parturients in Niger Delta University Teaching Hospital, Okolobiri, in the south-south region of Nigeria. Methods: The study was a retrospective case control study comprising 62 parturients with placenta praevia (cases) and 64 parturients without placenta praevia serving as control. Using a self-designed proforma data which include sociodemographic characteristics, past obstetric and gynaecological history and history of index pregnancy was extracted from patients’ medical records. Difference between cases and controls was explored using Chi-square test of proportion, while risk factors for placenta praevia were identified using a multivariate binary logistic regression analysis. Level of significance was set at pValue < 0.05. Results: The women with placenta praevia (33.4±4.9years) were significantly (t=4.88;p-0.001) older than women in the control group (29.3±4.67years). Parity significantly differs between the case and the control group(X2–40.64;p-0.001). Risk factors for placenta previa identified in our locality include grandmultiparity[OR=14.65,(95%CI:1.50–143.45)], age≥35years[OR = 4.96,( 95% CI:1.45–16.93)], previous caesarean section[OR=3.66(95%CI:1.13–11.81)], and history of previous abortion[OR=2.68,(95% CI 1.13 – 7.24)]. Conclusion: From this study, the risk factors for placenta praevia were grandmultiparity, maternal age ≥35 years, previous caesarean section and history of previous abortion. Caregivers should be aware of this to ensure a high index of suspicion and thereby have good knowledgeable anticipation in the management of these patients.