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The following is a summary of “Nationwide Assessment of Gestational Age Distribution at Delivery for Patients With Placenta Accreta Spectrum Disorder,” published in the February 2025 issue of Obstetrics and Gynecology by Matsuo et al. 

Researchers conducted a retrospective study to examine the distribution of gestational age at delivery among individuals with placenta accreta spectrum (PAS) in the United States.  

They analyzed 26,375 hospital deliveries with a diagnosis code for PAS using the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project National Inpatient Sample from 2016 to 2021. Descriptive analysis evaluated the gestational age distribution at delivery and obstetric characteristics. The incidence of PAS codes was assessed among 2,12,124,93 hospital deliveries.  

The results showed that 56.9% of individuals with PAS delivered preterm (before 37 weeks of gestation), while 43.1% delivered at term (37 weeks or more). Compared to those with preterm deliveries, individuals with term deliveries had higher rates of vaginal birth (32.0% vs 6.9%) and were more likely to deliver in rural (9.7% vs 2.3%) or small-bed-capacity hospitals (18.6% vs 8.4%). Placenta previa (9.3% vs 50.5%) and increta or percreta subtypes (8.6% vs 27.4%) were less common in term deliveries (all P <.001). The incidences of hemorrhage or blood transfusion or both (62.9% vs 71.5%), shock or coagulopathy or both (6.2% vs 9.8%), hysterectomy (25.6% vs 65.3%), urinary tract injury (2.5% vs 10.0%), and maternal mortality (0.0% vs 0.2%) were lower in term than preterm deliveries (all P <.001). Among all hospital deliveries, 1 in 804 had a PAS diagnosis, with the incidence decreasing from 1 in 83–300 in preterm deliveries to 1 in 705–3,037 after 37 weeks. The incidence of PAS increased by 15.4% (95% CI, 10.7–20.4), from 114.8 to 132.5 per 100,000 hospital deliveries over 6 years (P trend<.001).  

Investigators concluded the term deliveries in patients with PAS represented a proportion with unique clinical profiles and outcomes compared to preterm PAS deliveries. 

Source: journals.lww.com/greenjournal/abstract/9900/nationwide_assessment_of_gestational_age.1224.aspx