Epidemiology and Risk Factors of Placenta Accreta Spectrum in Pregnancies with Assisted Reproductive Technology: A Retrospective Study in Southwest of Iran

Background & Objective: Placenta accreta is a serious condition associated with abnormal placental attachment, leading to significant maternal and fetal complications. This study was performed with aim to explore the relationship between assisted reproductive technology (ART) related pregnancy and the incidence of placenta accreta, as well as to identify demographic characteristics and potential risk factors associated with this condition. Materials & Methods: This retrospective cross-sectional study was conducted on 22,413 women who underwent vaginal or cesarean delivery at Imam Khomeini Hospital in Ahvaz, Iran, from 2019 to 2022. Data were collected using a researcher-made checklist, which included demographic information and details regarding current and previous pregnancies. The student t-test and chi-square tests were used for comparison of medical and demographic characteristics between patients with and without placenta accreta. P<0.05 was considered statistically significant. Results: The rate of placenta accreta was significantly higher in IVF pregnancies (P=0.047). In patients with placenta accreta, 35.11% had a history of abortion compared to only 3.25% in the patients without accreta (P<0.001). Additionally, 80.85% of those with placenta accreta had placenta previa, whereas only 0.57% of those without this condition (P<0.001). Additionally, patients with placenta accreta had a higher mean number of previous cesarean deliveries (2.43 ± 1.001 vs. 0.71 ± 0.037, P<0.001) and the mean number of gestations (4.08 ± 1.33 vs. 2.16 ± 0.086, P<0.001). Conclusion: The findings of the present study demonstrated that IVF pregnancies have a higher incidence of placenta accreta. Furthermore, advanced maternal age, higher number of gestations, history of abortion, presence of placenta previa, and previous cesarean deliveries were associated with placenta accreta.