Association between Short Inter-Pregnancy Interval with Placenta Previa and Placenta Accreta Spectrum with Respect to Maternal Age at First Caesarean Delivery

Abstract

Objective: To determine the association between short inter-pregnancy interval and the occurrence of placenta previa and placenta accreta spectrum, with respect to maternal age at first caesarean delivery.

Study Design: Prospective observational study.

Place and Duration of Study: Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Centre (JPMC), Karachi, conducted over a period of 6 months.

Methodology: A total of 100 pregnant women with a history of previous caesarean section were included. Patients were categorized based on inter-pregnancy interval into short (<24 months) and normal (≥24 months). Maternal age at first caesarean delivery and obstetric characteristics were recorded. Diagnosis of placenta previa and placenta accreta spectrum was made using ultrasound and confirmed intraoperatively. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. The chi-square test was applied to determine associations, and a p-value ≤0.05 was considered statistically significant.

Results: Short inter-pregnancy interval (<24 months) was observed in 40% of patients. Placenta previa was diagnosed in 30% of cases, while placenta accreta spectrum was present in 18%. Placenta previa was significantly more frequent in the short interval group (55%) compared to the normal interval group (13%) (p < 0.05). Similarly, placenta accreta spectrum was observed in 35% of patients with short interval versus 7% in those with normal interval (p < 0.05). Women who had their first caesarean delivery at age <25 years showed higher rates of placenta previa (38%) and placenta accreta spectrum (25%) compared to those aged ≥25 years.

Conclusion: Short inter-pregnancy interval is a significant risk factor for placenta previa and placenta accreta spectrum, particularly among women with early-age caesarean delivery. Adequate birth spacing and patient counseling are essential to reduce the risk of abnormal placentation.