The association of placenta previa and assisted reproductive techniques: a meta-analysis

J Matern Fetal Neonatal Med. 2018 Jul;31(14):1940-1947. doi: 10.1080/14767058.2017.1332035. Epub 2017 Jun 6.


Background: Several epidemiological studies have determined that assisted reproductive techniques (ART) can increase the risk of placenta previa. To date, only a meta-analysis has been performed for assessing the relationship between placenta previa and ART. This meta-analysis was conducted to estimate the association between placenta previa and ART in singleton and twin pregnancies.

Methods: A literature search was performed in major databases PubMed, Web of Science, and Scopus from the earliest possible year to April 2017. The heterogeneity across studies was explored by Q-test and I2 statistic. The publication bias was assessed using Begg's and Egger's tests. The results were reported using odds ratio (OR) and relative risk (RR) estimates with its 95% confidence intervals (CI) using a random-effects model.

Results: The literature search yielded 1529 publications until September 2016 with 1,388,592 participants. The overall estimate of OR was 2.67 (95%CI: 2.01, 3.34) and RR was 3.62 (95%CI: 0.21, 7.03) based on singleton pregnancies. The overall estimate of OR was 1.50 (95%CI: 1.26, 1.74) based on twin pregnancies.

Conclusions: We showed based on odds ratio reports in observational studies that ART procedures are a risk factor for placenta previa.

Keywords: Placenta previa; assisted reproductive techniques; meta-analysis; pregnancy.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Female
  • Humans
  • Observational Studies as Topic
  • Placenta Previa / etiology*
  • Pregnancy
  • Pregnancy, Twin
  • Reproductive Techniques, Assisted / adverse effects*