The association between placenta abruption and congenital anomalies: A systematic review and meta-analysis

Abstract

Background

Congenital abnormalities (CAs) are a significant cause of death and disability among children worldwide. Identifying risk factors can help reduce the incidence and mortality associated with CAs. This study aimed to explore the relationship between placental abruption (PA) and congenital abnormalities (CAs).

Methods

A systematic search was conducted in PubMed (Medline), Web of Science, Scopus, and Science Direct, up to July 10, 2025. The analysis utilized a random-effects model. To evaluate heterogeneity among the studies, we applied the chi-square test (χ²) and the I² statistic. Additionally, regression tests, including Egger’s and Begg’s tests, were carried out to assess publication bias. The quality of observational studies was evaluated using the modified Newcastle–Ottawa Scale (NOS). A p-value of less than 0.05 was considered statistically significant, and the analysis was performed using Stata software, version 13.

Results

In total, six studies met the inclusion criteria and were included in this systematic review. A significant association was found, with PA increasing the risk of CAs (OR = 2.83; 95% CI: 1.88 to 3.79). Substantial heterogeneity was observed among the studies (I² = 91.9%, P < 0.001). After subgrouping, a significant association between PA and the risk of CAs was observed in both case-control studies (OR = 1.95, 95% CI: 1.51 to 2.38; I² = 0.0%, P = 0.523) and cohort studies (OR = 3.28, 95% CI: 1.68 to 4.88; I² = 95.1%, P < 0.001). Notably, homogeneity was found among the case-control studies.

Conclusion

Our study demonstrates a significant positive association between PA and CAs, but causality cannot be inferred. Thus, it is suggested to monitor for CAs in the fetus of mothers with PA.