Association of History of Cesarean Section with Placenta Previa: A Case Control Study

Abstract

Background: Placenta previa is a grave obstetric morbidity that enhances the risk of maternal and neonatal morbidity. Cesarean delivery has been identified as an important cause of its occurrence, albeit the level of association differs among populations. The development of local evidence provides the necessary impetus for informing preventive and clinical interventions. Objective: To determine the association of placenta previa with history of previous cesarean section in pregnant women. Study Design: Case-control study. Duration and Place of Study: The study was conducted from January 2025 to May 2025 at the Department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar. Methodology: A total of 130 women aged 25–40 years with singleton pregnancies beyond 28 weeks were enrolled. Sixty-five women diagnosed with placenta previa on ultrasound formed the case group, while 65 without placenta previa served as controls. Baseline demographics, comorbidities, and obstetric history including prior cesarean sections were recorded. Data analysis was performed using SPSS version 26, with chi-square and stratified analyses applied. Results: The mean age of the placenta previa group was 31.94±2.54 years compared to 29.86±2.52 years in controls. Previous cesarean section was significantly more frequent among cases (46.2%) than controls (23.1%) (p=0.006; OR=2.86, 95% CI:1.35–6.05). Stratification revealed a stronger association in women >30 years (OR=6.77, 95% CI:2.18–21.05) and in non-hypertensive women (OR=6.22, 95% CI:2.54–15.24). Conclusion: Women with a history of cesarean section are at nearly threefold increased risk of developing placenta previa, with risk further amplified in older and non-hypertensive subgroups.