OBJECTIVE: To investigate risk factors for blood transfusion in pregnancy. METHODS: In a population-based study, data from all women with singleton pregnancies (n=225 304) admitted for delivery in Taiwanese hospitals in 2002 were obtained from the National Health Insurance claims database. To identify risk factors for blood transfusion, a logistic regression model with generalized estimating equation was used to calculate the adjusted odds ratio (OR) and 95% confidence intervals (CI) for characteristics of the pregnant women, hospitals, clinics, and obstetricians. RESULTS: The incidence of blood transfusion was 1.43%. Cesarean delivery, vaginal birth after cesarean (VBAC), and repeat cesarean delivery had higher rates of blood transfusion than vaginal delivery, with an OR of 7.2 (95% CI, 6.38-8.02), 4.2 (95% CI, 2.52-6.87), and 5.9 (95% CI, 5.06-6.80), respectively. Other risk factors included extremes of age; pregnancies complicated by prepartum hemorrhage, placenta previa, pre-eclampsia, eclampsia, anemia, or systemic lupus erythematosus; and obstetricians with low or mid-to-low numbers of deliveries. CONCLUSION: The study has identified risk factors for blood transfusion in pregnancy on the basis of a nationwide database and provides useful information for obstetric practice. For women with a history of cesarean delivery, vaginal delivery might be considered owing to its lower incidence of transfusion.
OBJECTIVE: To investigate risk factors for blood transfusion in pregnancy. METHODS: In a population-based study, data from all women with singleton pregnancies (n=225 304) admitted for delivery in Taiwanese hospitals in 2002 were obtained from the National Health Insurance claims database. To identify risk factors for blood transfusion, a logistic regression model with generalized estimating equation was used to calculate the adjusted odds ratio (OR) and 95% confidence intervals (CI) for characteristics of the pregnant women, hospitals, clinics, and obstetricians. RESULTS: The incidence of blood transfusion was 1.43%. Cesarean delivery, vaginal birth after cesarean (VBAC), and repeat cesarean delivery had higher rates of blood transfusion than vaginal delivery, with an OR of 7.2 (95% CI, 6.38-8.02), 4.2 (95% CI, 2.52-6.87), and 5.9 (95% CI, 5.06-6.80), respectively. Other risk factors included extremes of age; pregnancies complicated by prepartum hemorrhage, placenta previa, pre-eclampsia, eclampsia, anemia, or systemic lupus erythematosus; and obstetricians with low or mid-to-low numbers of deliveries. CONCLUSION: The study has identified risk factors for blood transfusion in pregnancy on the basis of a nationwide database and provides useful information for obstetric practice. For women with a history of cesarean delivery, vaginal delivery might be considered owing to its lower incidence of transfusion.
Authors: Shayna N Conner; Methodius G Tuuli; Ryan Colvin; Anthony L Shanks; George A Macones; Alison G Cahill Journal: Am J Perinatol Date: 2015-05-22 Impact factor: 1.862
Authors: J A Patterson; C L Roberts; J P Isbister; D O Irving; M C Nicholl; J M Morris; J B Ford Journal: Vox Sang Date: 2014-08-04 Impact factor: 2.144