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The following is a summary of “Incidence and causes of perinatal death in prenatally diagnosed vasa previa: a systematic review and meta-analysis,” published in the January 2024 issue of Obstetrics and Gynecology by Conyers, et al.

For a study, researchers sought to assess the perinatal mortality associated with prenatally diagnosed vasa previa and determine the proportion of perinatal deaths directly attributable to vasa previa.

They systematically searched PubMed, Scopus, Web of Science, and Embase databases from January 1, 1987, to January 1, 2023. Included were all studies (cohort studies, case series, or reports) involving patients with a prenatal diagnosis of vasa previa. Case series or reports were excluded from the meta-analysis. Cases lacking prenatal diagnosis were also excluded. Meta-analysis was conducted using R software (version 4.2.2). Data were logit transformed and pooled using the fixed-effects model. Between-study heterogeneity was assessed by I², and publication bias was evaluated using funnel plots and the Peters regression test. The risk of bias was assessed using the Newcastle-Ottawa scale.

A total of 113 studies with 1,297 pregnant individuals were included, comprising 25 cohort studies (1,167 pregnancies) and 88 case series or reports (130 pregnancies). Among these, 13 perinatal deaths occurred, including 2 stillbirths and 11 neonatal deaths. The overall perinatal mortality rate in cohort studies was 0.94% (95% CI: 0.52–1.70; I²=0.0%). Pooled perinatal mortality attributed to vasa previa was 0.51% (95% CI: 0.23–1.14; I²=0.0%). Stillbirth and neonatal death rates were 0.20% (95% CI: 0.05–0.80; I²=0.0%) and 0.77% (95% CI: 0.40–1.48; I²=0.0%), respectively.

Perinatal mortality following a prenatal diagnosis of vasa previa is infrequent, with approximately half of the cases not directly linked to vasa previa. The findings offered valuable insights for counseling physicians and provided reassurance to pregnant individuals with prenatal vasa previa diagnoses.

Reference: ajog.org/article/S0002-9378(23)00383-6/abstract