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Sometimes we face with unexpected PAS cases which is potentially higher maternal mortality and morbidity compared with expected cases. The present study was conducted to examine the prevalence of PAS and to elucidate its risk factors using a large Japanese birth cohort study.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We reviewed the results of a nationwide prospective birth cohort study in Japan, and identified 90,554 participants treated from 2011 to 2014 in 15 regional centers. Multiple regression models were created to identify the risk factors for PAS. These data were obtained from self-reported questionnaires or patient medical records.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>This analysis consisted of 202 cases of PAS (18 with placenta previa and 184 without placenta previa) and 90,352 cases without PAS. The multiple logistic regression analysis showed that placenta previa (adjusted odds ratio [aOR]: 12.86, 95% confidence interval [CI] 7.70\u201321.45, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), assisted reproductive technology-related pregnancies (aOR: 6.78, 95% CI 4.54\u201310.14, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), smoking during pregnancy (aOR: 1.95, 95% CI 1.15\u20133.31, <jats:italic>P<\/jats:italic>\u2009=\u20090.013), more than two previous cesarean sections (aOR: 2.51, 95% CI 1.35\u20134.67, <jats:italic>P<\/jats:italic>\u2009=\u20090.004), and uterine anomalies (aOR: 3.97, 95% CI 1.24\u201312.68, <jats:italic>P<\/jats:italic>\u2009=\u20090.020) increased the risk of PAS.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>In general population, placenta previa, assisted reproductive technology-related pregnancy, smoking during pregnancy, repeated cesarean sections, and uterine anomalies were risk factors for PAS in the Japanese population.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12884-019-2608-9","type":"journal-article","created":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T16:02:56Z","timestamp":1574870576000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":82,"title":["Risk factors for placenta accreta spectrum: findings from the Japan environment and Children\u2019s study"],"prefix":"10.1186","volume":"19","author":[{"name":"the Japan Environment and Children\u2019s Study (JECS) Group","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7782-3396","authenticated-orcid":false,"given":"Hyo","family":"Kyozuka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko","family":"Yamaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiya","family":"Fujimori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuaki","family":"Hosoya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Yasumura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadahiko","family":"Yokoyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Hashimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,27]]},"reference":[{"key":"2608_CR1","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.1097\/01.AOG.0000219750.79480.84","volume":"107","author":"RM Silver","year":"2006","unstructured":"Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA, et al. 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The JECS was conducted in accordance with the Declaration of Helsinki and other internationally valid regulations and guidelines for research on human subjects, and written informed consent was obtained from all participants. In JECS study, the minimum maternal age of participants was 15\u2009years old. Written informed consent from both participants and their parent are required for JECS study if participants is under the age of 20.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"447"}}