Maternal and Neonatal Health Outcomes in Placenta Accreta: Short-Term Morbidity and Long-Term Neurodevelopmental Impacts

Placenta accreta (PA) is a serious maternal complication defined by abnormal attachment of the placental trophoblastic tissue to the myometrial wall of the uterus. Objectives: To evaluate the effect of placenta accreta on maternal morbidity and neonatal health outcomes, with an emphasis on long-term neurodevelopmental effects. Methods: This retrospective study was conducted at Social Security Teaching Hospital, Lahore, from October 2022 to March 2023. A total of 231 patient data was gathered for the study, comprising 77 infants delivered after third-trimester bleeding due to placenta accreta and 154 gestational age-matched controls. The maternal outcomes assessed included rates of postpartum hemorrhage, cesarean section, and peripartum hysterectomy. Neonatal outcomes were evaluated by Apgar scores, the incidence of respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), and hypoglycemia. Long-term neurodevelopmental outcomes, including cerebral palsy (CP) and minor neurodevelopmental abnormalities, were followed up at 2 years. Statistical analyses were conducted using one-way ANOVA and Chi-square test using SPSS-26. Results: Infants born to mothers with PA had lower Apgar scores at 1 minute (24.7% vs. 5.2% in controls; adjusted OR-5.67), higher rates of RDS (40.3% vs. 7.8%; adjusted OR-7.42), and severe IVH (11.7% vs. 1.9%; adjusted OR-6.30). Hypoglycemia occurred in 18.2% of the PA group compared to 3.2% in controls (adjusted OR-6.41). At 24 months, 7.8% of infants with PA had cerebral palsy (adjusted OR-13.5) and 6.5% had severe developmental delays (adjusted OR-10.4). Conclusions: It was concluded that PA is a serious risk factor for maternal and neonatal morbidity and long-term neurodevelopmental impairment.