Placental Abruption and Early Cardiovascular Risk

A new study in the Journal of the American Heart Association reported that offspring born after placental abruption had higher observed risks of early cardiovascular morbidity and mortality, including an estimated 4.6-fold higher risk of cardiovascular death by age 28 compared with offspring without this pregnancy complication.

This was a population-based retrospective cohort using New Jersey patient data, and it was limited to singleton births from 1993 through 2020. There were roughly 2.95 million births, including about 28,641 exposed to placental abruption, with follow-up extending up to 28 years. Outcomes were ascertained through linked hospitalization and mortality records, enabling evaluation of cardiovascular-related hospitalizations and cardiovascular mortality over time using registry data. Within this statewide data environment, exposed and unexposed offspring were compared using routinely collected records to capture events across childhood and early adulthood.

For nonfatal outcomes, offspring exposed to placental abruption had roughly a threefold higher risk of hospitalization for heart-related conditions and an approximately 2.4-fold higher risk of stroke hospitalization than those unexposed. Heart- and stroke-related risks were higher among children younger than 1 year.

Investigators conducted sibling comparison analyses (treating each mother as her own control) and observed similar associations to the main findings, including for cardiovascular death by age 28.

This design cannot establish causality, and the associations are presented as observational findings rather than proof of a causal relationship.