Assessment of Risk Factors Associated with Placenta Previa in a Tertiary Health Institution in Southeast Nigeria

Background: Placenta previa is a significant obstetric complication that can lead to adverse maternal and fetal outcomes. Understanding its risk factors is crucial for early diagnosis and management, particularly in healthcare settings in Nigeria. Objective: To assess the risk factors associated with placenta previa among pregnant women in a tertiary health institution in Southeast Nigeria. Materials and Methods: This prospective descriptive study was conducted over two years (January 2021 to December 2022) and included all pregnant women who delivered in the institution during this period. Data were collected using a structured, interviewer-administered questionnaire after obtaining informed consent from participants. Placenta previa was identified through abdominal ultrasonography, and all confirmed cases were managed according to the MacAfee regimen. Descriptive statistics and chi-square tests were used to analyze the data using SPSS version 26. Results: Out of the 8,766 deliveries recorded in the hospital during the period of this study, 94 (1.07%) were diagnosed with placenta previa. Significant associations were found between placenta previa and factors such as advanced maternal age (≥40 years, p=0.041), history of complications during previous pregnancies (p=0.039), previous cesarean section (p=0.009), history of placenta previa (p<0.001), multiple pregnancies (p=0.001), bleeding during pregnancy (p<0.001), and uterine surgeries apart from cesarean sections (p=0.001). Smoking history was also a significant risk factor (p<0.001). Conclusion: The study identified several risk factors for placenta previa, including advanced maternal age, previous cesarean section, history of placenta previa, multiple pregnancies, uterine surgeries, and smoking. These findings highlight the importance of targeted interventions and close monitoring of at-risk pregnant women to reduce complications.