To investigate the risk factors and pregnancy outcome of placental accreta spectrum disorders.

This is a retrospective cohort study of singleton pregnant women (n=48 650), who gave birth in the Third Affiliated Hospital of Guangzhou Medical University from January 2009 to December 2017. The pregnant women were divided into the PAS (placenta accrete spectrum) group and the control group, and the risk factors and pregnancy outcomes of the two groups were compared.

Univariate analysis showed that age (≥35 years old), high school education level and below, pregnancy times (>3 times), multipara, history of induced abortion, history of cesarean section, in vitro fertilization-embryo transfer (IVF-ET) and placenta previa were the related risk factors for placenta accreta spectrum disorders (P<0.05). Multivariate logistic regression analysis showed that the independent risk factors for placenta accreta spectrum disorders were the history of cesarean section (OR=2.254, 95%CI: 1.917-2.650), IVF-ET (OR=1.591, 95%CI: 1.212-2.089), placenta previa (OR=28.282, 95%CI: 24.338-32.866). Compared with the control group, the incidence rate of premature delivery, cesarean section, postpartum hemorrhage, diffused intravascular coagulation, puerperal infection, hysterectomy, low birth weight infants, low neonatal Apgar score (1 minute), and ICU admission in the PAS group were significantly higher (P<0.05).

The history of cesarean section, IVF-ET and placenta previa are independent risk factors for pregnancies with placenta accreta spectrum disorders, and the pregnancy outcome is poor.