Abstract
Objective: This study aims to estimate the familial risk of
placental abruption using a large population database. Design:
Retrospective familial aggregation study of placental abruption
utilizing a case-control design. Population: The Utah
Population Database is a genealogic database of over 11 million
individuals, which contains medical and demographic information linked
to official records dating back to the 1900s. Methods: Cases of
placental abruption and controls were ascertained from birth
certificates, death certificates, and inpatient medical records.
Controls were matched 3:1 to cases based on age, parity, and number of
relatives in the database. Familial risk of placental abruption was
estimated using generalized linear mixed-effect regression and
conditional logistic regression. Main outcome measures:
Unadjusted and adjusted odds of placental abruption between first-,
second-, and third-degree relatives. Results: Of 1,168,378
pregnancies analyzed in the Utah Population Database, 32,823 cases
(2.8%) of placental abruption were identified. First-degree relatives
inherit an adjusted odds of placental abruption estimated at 1.18 (95%
CI: 1.12 – 1.23) when a family member has had at least one placental
abruption, and 1.38 (95% CI: 1.17 – 1.63) with two or more placental
abruptions. The estimated effect is lower for second- and third-degree
relatives. After controlling for clinical risk factors, individuals
inherit an adjusted odds of placental abruption estimated at 1.16 (95%
CI: 1.03 – 1.31, p=0.014) with a first-degree family history of
placental abruption. The estimates for second- and third-degree
relatives using this method are not statistically significant.
Conclusion: These findings represent an argument for the
inheritance of genetic factors which predispose the occurrence of
placental abruption.