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Journal of Pregnancy
Volume 2017, Article ID 3194814, 5 pages
https://doi.org/10.1155/2017/3194814
Clinical Study

Circadian Variation in the Onset of Placental Abruption

1Department of Obstetrics & Gynecology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
2Department of Obstetrics & Gynecology, School of Medicine, Kyorin University, Tokyo, Japan

Correspondence should be addressed to Seishi Furukawa; moc.liamg@ihsies64abiihs

Received 22 August 2016; Revised 29 November 2016; Accepted 21 December 2016; Published 9 January 2017

Academic Editor: R. L. Deter

Copyright © 2017 Masanao Ohhashi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To determine circadian variation in the onset of placental abruption. Methods. A retrospective study involving 115 placental abruptions, divided into four subgroups based on initial symptoms comprising abdominal pain, vaginal bleeding, both abdominal pain and bleeding, or other symptoms. The time of the initial symptom was considered the disease onset. We analyzed the frequency of disease onset and adverse perinatal outcome including perinatal death relative to the daily four 6-hour intervals. Results. Abdominal pain displayed significant circadian variation regarding the period of onset with higher levels from 0:00 AM to 6:00 AM (65%) compared with 0:00 PM to 6:00 PM (24%, ). Vaginal bleeding did not display significant circadian variation (). Adverse perinatal outcome showed significant circadian variation with a higher occurrence of perinatal death from 0:00 AM to 6:00 AM (35%) compared with 0:00 PM to 6:00 PM (0%, ). After adjustment using variables of abdominal pain and time period, both variables significantly affected perinatal death (odds ratio: 13.0 and 2.2, resp.). The risk of adverse perinatal outcome increased significantly when abdominal pain occurred, except for the period 0:00 PM to 6:00 PM (OR, 9.5). Conclusion. Placental abruption beginning with abdominal pain has circadian variation.