Articles

The association between previous abortion and risk of placenta accreta spectrum: a meta-analysis

ABSTRACT

Background. Several studies have yielded conflicting results regarding the potential link between previous abortion and placenta accreta spectrum (PAS), contributing to ongoing controversy on the matter. To address this discrepancy, we conducted a meta-analysis to elucidate the association between previous abortion and the risk of PAS.

Methods. To examine the association between prior abortion and PAS, we systematically searched major databases, including PubMed (Medline), Web of Science, and Scopus. A random-effects model was used for the meta-analysis, and study quality was evaluated using the Newcastle-Ottawa Scale (NOS).

Results. The final analysis included five cohort studies and six case-control studies with a total population of 115,422 participants. We examined the association between previous abortion and the risk of PAS based on crude and adjusted studies. The association between previous abortion and the risk of PAS in crude studies was 1.62 (95%CI 1.46- 1.77; I2 = 17.8%). In adjusted studies, the association was 2.37 (95%CI 1.62-3.12; I2=79.5%). Substantial heterogeneity was observed in studies using adjusted analyses, while minimal heterogeneity was found in studies reporting crude estimates.

Conclusions. This meta-analysis reported that prior abortion is a risk factor for PAS. Given these significant implications, healthcare providers should incorporate PAS risk assessment into pre-abortion evaluations and carefully consider the choice of termination method.

Key words

Placenta accreta spectrum; abortion; meta-analysis; pregnancy.

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