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dc.contributor.authorAnanth, Cande V.en_US
dc.contributor.authorKeyes, Katherine M.en_US
dc.contributor.authorHamilton, Avaen_US
dc.contributor.authorGissler, Mikaen_US
dc.contributor.authorWu, Chunsenen_US
dc.contributor.authorLiu, Shiliangen_US
dc.contributor.authorLuque-Fernandez, Miguel Angelen_US
dc.contributor.authorSkjærven, Rolven_US
dc.contributor.authorWilliams, Michelle A.en_US
dc.contributor.authorTikkanen, Minnaen_US
dc.contributor.authorCnattingius, Svenen_US
dc.date.accessioned2015-07-13T18:45:18Z
dc.date.issued2015en_US
dc.identifier.citationAnanth, C. V., K. M. Keyes, A. Hamilton, M. Gissler, C. Wu, S. Liu, M. A. Luque-Fernandez, et al. 2015. “An International Contrast of Rates of Placental Abruption: An Age-Period-Cohort Analysis.” PLoS ONE 10 (5): e0125246. doi:10.1371/journal.pone.0125246. http://dx.doi.org/10.1371/journal.pone.0125246.en
dc.identifier.issn1932-6203en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:17295566
dc.description.abstractBackground: Although rare, placental abruption is implicated in disproportionately high rates of perinatal morbidity and mortality. Understanding geographic and temporal variations may provide insights into possible amenable factors of abruption. We examined abruption frequencies by maternal age, delivery year, and maternal birth cohorts over three decades across seven countries. Methods: Women that delivered in the US (n = 863,879; 1979–10), Canada (4 provinces, n = 5,407,463; 1982–11), Sweden (n = 3,266,742; 1978–10), Denmark (n = 1,773,895; 1978–08), Norway (n = 1,780,271, 1978–09), Finland (n = 1,411,867; 1987–10), and Spain (n = 6,151,508; 1999–12) were analyzed. Abruption diagnosis was based on ICD coding. Rates were modeled using Poisson regression within the framework of an age-period-cohort analysis, and multi-level models to examine the contribution of smoking in four countries. Results: Abruption rates varied across the seven countries (3–10 per 1000), Maternal age showed a consistent J-shaped pattern with increased rates at the extremes of the age distribution. In comparison to births in 2000, births after 2000 in European countries had lower abruption rates; in the US there was an increase in rate up to 2000 and a plateau thereafter. No birth cohort effects were evident. Changes in smoking prevalence partially explained the period effect in the US (P = 0.01) and Sweden (P<0.01). Conclusions: There is a strong maternal age effect on abruption. While the abruption rate has plateaued since 2000 in the US, all other countries show declining rates. These findings suggest considerable variation in abruption frequencies across countries; differences in the distribution of risk factors, especially smoking, may help guide policy to reduce abruption rates.en
dc.language.isoen_USen
dc.publisherPublic Library of Scienceen
dc.relation.isversionofdoi:10.1371/journal.pone.0125246en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446321/pdf/en
dash.licenseLAAen_US
dc.titleAn International Contrast of Rates of Placental Abruption: An Age-Period-Cohort Analysisen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalPLoS ONEen
dash.depositing.authorWilliams, Michelle A.en_US
dc.date.available2015-07-13T18:45:18Z
dc.identifier.doi10.1371/journal.pone.0125246*
dash.authorsorderedfalse
dash.contributor.affiliatedWilliams, Michelle


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