A study published today in the Journal of the American Heart Association reveals that placental abruption—a serious pregnancy complication where the placenta separates from the uterus before delivery—may increase the child's risk of cardiovascular disease later in life. Researchers found that individuals born to mothers with placental abruption were about 4.6 times more likely to die from cardiovascular disease by age 28 compared to those without this complication. They were also nearly three times more likely to be hospitalized for heart-related conditions such as heart failure, ischemic heart disease, heart attack, and blocked arteries.
The study, part of the Placental Abruption and Cardiovascular Event Risk (PACER) project, analyzed nearly 3 million births in New Jersey from 1993 to 2020. Of these, approximately 1% (28,641 pregnancies) were affected by placental abruption. The offspring were followed for up to 28 years using hospital and mortality records. The elevated cardiovascular risks persisted even after adjusting for genetic and environmental factors by comparing siblings.
"Our study suggests that placental abruption needs to be taken as a very serious complication for the mother and also potentially affecting the baby's cardiovascular health later in life," said lead author Cande Ananth, Ph.D., M.P.H., chief of the division of epidemiology and biostatistics at Rutgers Robert Wood Johnson Medical School. "Most treatments after a placental abruption focus on following the mother after a pregnancy complication. Our study shows it is important that their children are also monitored to identify potential complications due to their increased risk of cardiovascular disease."
The risk of stroke hospitalization was 2.4 times higher for children exposed to placental abruption, and these risks were even higher among children younger than 1 year old. According to the American Heart Association's 2026 Heart Disease and Stroke Statistics, placental abruption occurs in 0.5% to 1% of pregnancies. Risk factors include older maternal age, multiple gestations, smoking, alcohol use, cocaine use, and high blood pressure.
Stacey E. Rosen, M.D., FAHA, volunteer president of the American Heart Association, who was not involved in the study, emphasized the importance of monitoring both mother and child. "We know that women who have complications during pregnancy are often at higher risk for heart disease and stroke, and that's why the American Heart Association recommends closely monitoring these women, especially in the first three months to a year after birth," she said. "The findings of this study reinforce that it is also important to monitor their babies for risks and identify opportunities to reduce the potential impact these complications may have on them not only right after birth, but throughout their lifetime."
The study authors note that more research is needed to understand the mechanisms linking placental abruption to later cardiovascular disease. The findings are limited by the observational nature of the data, which cannot prove cause and effect. Nevertheless, the results highlight the need for long-term cardiovascular monitoring of children born from pregnancies complicated by placental abruption.
