Placenta accreta: depth of invasion and neonatal outcomes

OBJECTIVE: The purpose of this study was to compare the risk of adverse neonatal outcomes between women with placenta accreta and placenta increta or percreta. METHODS: This was a single institution retrospective cohort study of women with abnormal placentation (placenta accreta, increta, and percreta) who delivered from 1982-2002. Cases were divided into superficial invasion (placenta accreta) and deep invasion (placenta increta or percreta), and compared. The primary outcomes studied were gestational age at delivery, birth weight, and size for gestational age. RESULTS: 103 viable pregnancies with abnormal placentation were observed (1.6/1000 pregnancies). Cases of deep invasion had higher parity and were more likely to have had a prior cesarean delivery. The mean gestational age at delivery was 33 5/7 weeks with deep placental invasion and 35 2/7 weeks in the superficial invasion group (p = 0.18). Rates of preterm birth were 64.7% and 52.3% (p = 0.43) and low birthweight were 24% and 29% (p = 0.76) in the deep and superficial invasion groups respectively. There were no differences in the remaining outcomes. CONCLUSIONS: Neonatal outcomes of pregnancies complicated by placenta increta and percreta are not different than those with placenta accreta.