Is twin gestation an independent risk factor for placenta accreta spectrum?

We read with interest the article published in April 2021 by Matsuzaki et al1, which focused on one of the most severe maternal complications known as placenta accreta spectrum (PAS). The study found that among the women who underwent cesarean delivery, multiple gestation was associated with a lower likelihood of having PAS in a national representative sample of the United States. As the authors acknowledged, Miller et al2 reported the opposite results, in which twin gestation was associated with an increased risk of PAS.