{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T14:13:07Z","timestamp":1783519987239,"version":"3.55.0"},"reference-count":43,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Placental abruption (PA) is an unpredictable obstetric complication associated with substantial maternal and fetal\/neonatal morbidity and mortality in the index and subsequent pregnancies. The previous PA severity classification categorizes more than two-thirds of cases as severe, which limits its clinical utility despite its association with adverse maternal outcomes. Objective: We aimed to develop a novel, clinically applicable PA severity classification and to determine its ability to predict its recurrence in subsequent pregnancies. Study design: This retrospective, population-based cohort study included medical records of all women who delivered at our medical center from 2001 to 2021. Pregnancies complicated by chromosomal abnormalities or major congenital anomalies were excluded. The novel PA severity classification included maternal (transfusion of \u22654 units of red blood cells, admission to an intensive care unit, DIC, hysterectomy, or maternal death) and neonatal (birth asphyxia, hypoxic\u2013ischemic encephalopathy, umbilical cord blood acidosis defined as pH &lt; 7.0, neonatal intensive care unit admission at \u226535 weeks gestation, or perinatal death) complications. Maternal characteristics, clinical features, and perinatal outcomes were compared between the novel and the existing PA severity classifications. A multivariate regression model was used to determine the association between PA severity and the risk of its recurrent in subsequent pregnancies. Results: Our cohort included 298,281 deliveries; of them, 1567 (0.5%) had PA. The rate of severe PA was lower in the novel vs. the existing classification (p &lt; 0.001). Within the novel classification, severe PA was associated with higher rates of mild and severe preeclampsia and lower mean fibrinogen concentrations and platelet counts compared with mild abruption (all p &lt; 0.001). Severe PA was independently associated with an increased risk of recurrence in subsequent pregnancies (OR 1.82, 95% CI 1.05\u20133.14). Conclusions: We propose a novel, clinically relevant PA severity classification that accurately identifies severe disease providing prognostic information regarding the risk of PA recurrence in future pregnancies.<\/jats:p>","DOI":"10.3390\/jcm15135308","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:19:31Z","timestamp":1783430371000},"page":"5308","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A New Severity Index for Placental Abruption Predicts Recurrence Risk in Future Pregnancies"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0583-5618","authenticated-orcid":false,"given":"Lior","family":"Kerber","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Joyce & Irving Goldman Medical School, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shai","family":"Rippel","sequence":"additional","affiliation":[{"name":"Department of Information Systems and Software Engineering, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1369-801X","authenticated-orcid":false,"given":"Ori","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Information Systems and Software Engineering, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6956-3341","authenticated-orcid":false,"given":"Lior","family":"Rokach","sequence":"additional","affiliation":[{"name":"Department of Information Systems and Software Engineering, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efrat","family":"Spiegel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taeer","family":"Avnon","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Joyce & Irving Goldman Medical School, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Offer","family":"Erez","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Joyce & Irving Goldman Medical School, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"},{"name":"Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel"},{"name":"Department of Obstetrics and Gynecology, Hutzel Women\u2019s Hospital, School of Medicine, Wayne State University, Detroit, MI 48202, USA"},{"name":"Obstetric High Risk Pregnancies Clinics, Division of Obstetrics and Gynecology, Soroka University Medical Center, Beer Sheva 84101, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"ref_1","unstructured":"Landon, M.B., Galan, H.L., Jauniaux, E.R.M., Driscoll, D.A., Berghella, V., Grobman, W.A., Kilpatrick, S.J., and Cahill, A.G. 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