Placental Abruption Genetic Epidemiology and Triggers (PAGE) Study

Objectives

To provide critical new information that may elucidate the pathophysiology and epidemiology of abruptio placenta (AP) and early preterm delivery (ePTD ) by evaluating the influence of environmental and lifestyle factors as triggers of abruptio placenta and by identifying genetic risk factors for AP and ePTD.

Background

Abruptio Placentae (AP), the premature separation of the placenta, is a life threatening obstetric condition that complicates 1-2% of all pregnancies.  It leads to maternal death, neonatal stillbirth and short and long term poor health of children. Pathophysiologic mechanisms involved in AP include uteroplacental ischemia, underperfusion, chronic hypoxia, and infarctions. On this basis, investigators have begun to conceptualize abruption as an “ischemic placental disorder” characterized by acute and chronic pathophysiological features. The etiology of AP remains unknown, though results from previous studies suggest some risk factors and emerging evidence suggest a significant genetic component in the pathogenesis of AP.

Study Design and Setting

We are using a self-matched case-crossover design to evaluate intimate partner violence and lifestyle factors as potential “triggers” of AP and early preterm delivery, as well as a case-control replicative study design to study genetic variants influencing the pathogenesis of AP. This is a multi-hospital study based in Lima Peru; in a low income urban setting.

Study Team

United States
Dr. Michelle Williams
Dr. Bizu Gelaye

Peru
Dr. Sixto Sanchez
Ms. Elena Sanchez