This is unclear. The strongest association is with trauma and hypertension.
Other factors which have been associated with abruption are:
- past obstetric history of abruptio placentae
 - pregnancy induced or essential hypertension - in up to 25% of patients with abruption
 - multiple pregnancy
 - increasing age
 - high parity
 - low socio-economic status
 - renal infection
 - drugs - smoking, cocaine
 - uterine anomaly or tumour
 - sudden uterine decompression - may endanger the second or subsequent children in multiple births
 - short umbilical cord
 - pressure from the enlarged uterus on the inferior vena cava
 
It has been suggested also that abruption may be caused by folate deficiency because:
- abruptio placentae is found more often in multiparous women with low socio-economic status
 - there is an association between megaloblastic anaemia and abruption However:
 - megaloblastic anaemia is common in Nigeria but abruption is not
 - folate supplements are not protective