Shanny Sade1, Adi Y Weintraub2, Yael Baumfeld2, Dvora Kluwgant2, David Yohay2, Reut Rotem3, Gali Pariente2. 1. Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, PO Box 151, Beer-Sheva, Israel. shanny.ogen@gmail.com. 2. Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, PO Box 151, Beer-Sheva, Israel. 3. Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University Medical School of Jerusalem, Jerusalem, Israel.
Abstract
OBJECTIVE: Postpartum hemorrhage is an obstetric emergency with a rising incidence. The aim of this study was to identify trends in the specific contribution of various risk factors for postpartum hemorrhage by observing their odds ratios throughout different time periods. STUDY DESIGN: In this population-based retrospective cohort study trends of change in odds ratios for known risk factors for postpartum hemorrhage occurring in three consecutive eight-year intervals between 1988 and 2014 were compared. Two multivariable logistic regression models were used in order to identify independent risk factors for postpartum hemorrhage in our population. Trends of various risk factors were compared along the time period of the study. RESULTS: The incidence of postpartum hemorrhage increased from 0.5% to 1988 to 0.6%. Using logistic regression models, preeclampsia, vacuum extraction delivery, retained placenta, perineal or vaginal tears and delivery of a large for gestational age neonate were recognized as independent risk factors for postpartum hemorrhage. While the odds ratios for perineal or vaginal tears significantly increased, odds ratios for delivery of a large for gestational age neonate significantly decreased. Odds ratios for the other risk factors did not change significantly. CONCLUSION: In our study, not only did the rates of statistically significant risk factors for postpartum hemorrhage change during the study period, the specific contribution of each risk factor changed as well. Having a better understanding of these trends might augment our ability to predict this grave obstetric complication and improve maternal outcomes in the future.
OBJECTIVE: Postpartum hemorrhage is an obstetric emergency with a rising incidence. The aim of this study was to identify trends in the specific contribution of various risk factors for postpartum hemorrhage by observing their odds ratios throughout different time periods. STUDY DESIGN: In this population-based retrospective cohort study trends of change in odds ratios for known risk factors for postpartum hemorrhage occurring in three consecutive eight-year intervals between 1988 and 2014 were compared. Two multivariable logistic regression models were used in order to identify independent risk factors for postpartum hemorrhage in our population. Trends of various risk factors were compared along the time period of the study. RESULTS: The incidence of postpartum hemorrhage increased from 0.5% to 1988 to 0.6%. Using logistic regression models, preeclampsia, vacuum extraction delivery, retained placenta, perineal or vaginal tears and delivery of a large for gestational age neonate were recognized as independent risk factors for postpartum hemorrhage. While the odds ratios for perineal or vaginal tears significantly increased, odds ratios for delivery of a large for gestational age neonate significantly decreased. Odds ratios for the other risk factors did not change significantly. CONCLUSION: In our study, not only did the rates of statistically significant risk factors for postpartum hemorrhage change during the study period, the specific contribution of each risk factor changed as well. Having a better understanding of these trends might augment our ability to predict this grave obstetric complication and improve maternal outcomes in the future.
Authors: Rezan Abdul-Kadir; Claire McLintock; Anne-Sophie Ducloy; Hazem El-Refaey; Adrian England; Augusto B Federici; Chad A Grotegut; Susan Halimeh; Jay H Herman; Stefan Hofer; Andra H James; Peter A Kouides; Michael J Paidas; Flora Peyvandi; Rochelle Winikoff Journal: Transfusion Date: 2014-03-12 Impact factor: 3.157
Authors: Cande V Ananth; Christina M Duzyj; Stacy Yadava; Marlene Schwebel; Alan T N Tita; K S Joseph Journal: Hypertension Date: 2019-09-09 Impact factor: 10.190