Table 4.
Factors associated with post-partum hemorrhage: Results from logistic regression analyses
| |
Blood loss ≥ 700 mL |
|||
|---|---|---|---|---|
| |
No oxytocin prophylaxis (N = 8154) |
Oxytocin prophylaxis (N = 30569) |
||
| OR (95% CI) | p-value | OR (95% CI) | p-value | |
|
Receipt of AMTSL components* |
||||
| None |
ref |
- |
- |
- |
| UM only |
1.14 (0.87-1.50) |
0.349 |
- |
- |
| CCT only |
0.53 (0.42-0.66) |
0.000 |
- |
- |
| CCT + UM |
1.66 (1.31-2.10) |
0.000 |
- |
- |
| Oxytocin (IM) only |
- |
- |
ref |
- |
| Oxytocin (IM) + CCT |
- |
- |
0.33 (0.25-0.45) |
0.000 |
| Oxytocin (IM) + CCT + UM |
- |
- |
0.65 (0.48-0.88) |
0.006 |
| Oxytocin (IV) only |
- |
- |
0.24 (0.12-0.50) |
0.000 |
| Oxytocin (IV) + CCT |
- |
- |
0.28 (0.14-0.55) |
0.000 |
| Oxytocin (IV) + CCT + UM |
- |
- |
0.79 (0.62-0.99) |
0.044 |
|
Labor induced/augmented |
- |
- |
0.91 (0.76-1.09) |
0.284 |
|
Parity |
||||
| 0 |
1.24 (1.04-1.48) |
0.016 |
2.36 (2.01-2.76) |
0.000 |
| 1-3 |
ref |
- |
ref |
- |
| 4+ |
0.61 (0.32-1.16) |
0.130 |
0.51 (0.29-0.88) |
0.017 |
|
Multiple pregnancy |
1.33 (0.68-2.62) |
0.401 |
1.62 (0.97-2.70) |
0.065 |
|
Gestational age at delivery weeks |
||||
| <37 |
0.40 (0.22-0.73) |
0.002 |
0.32 (0.20-0.51) |
0.000 |
| 37-41 |
ref |
- |
ref |
- |
| 42+ |
0.82 (0.46-1.45) |
0.495 |
1.48 (0.93-2.36) |
0.102 |
|
Anemia** |
1.19 (1.00-1.42) |
0.049 |
1.28 (1.11-1.49) |
0.001 |
|
Prior known post-partum hemorrhage |
2.18 (0.74-6.48) |
0.159 |
5.17 (3.21-8.31) |
0.000 |
|
Age (years) |
||||
| <20 |
1.24 (0.89-1.73) |
0.195 |
0.78 (0.61-0.99) |
0.041 |
| 20-34 |
ref |
- |
ref |
- |
| 35+ |
0.94 (0.66-1.32) |
0.715 |
1.46 (1.07-1.99) |
0.017 |
|
Educational attainment |
||||
| No education |
ref |
- |
ref |
- |
| Primary school |
0.87 (0.67-1.13) |
0.288 |
1.14 (0.91-1.43) |
0.250 |
| Secondary or higher | 1.03 (0.81-1.32) | 0.786 | 1.20 (1.00-1.44) | 0.045 |
AMTSL denotes active management of the third stage of labor; CCT, controlled cord traction; and UM, uterine massage, IM, intramuscular; and IV, intravenous.
*Additional tests for differences between AMTSL groups in the oxytocin prophylaxis regimen were obtained by re-running the regression model with alternate reference categories. Results were as follows:
a. Oxy (IV) + CCT vs. oxy (IV) (ref): OR = 1.13, 95% CI 0.43-2.96.
b. Oxy (IM) + CCT + UM vs. oxy (IM) + CCT (ref): OR = 1.94, 95% CI 1.43-2.65.
c. Oxy (IV) + CCT + UM vs. oxy (IV) + CCT (ref): OR = 2.86, 95% CI 1.46-5.59.
d. Oxy (IV) + CCT vs. oxy (IM) + CCT (ref): OR = 1.21, 95% CI 0.60-2.46.
e. Oxy (IM) + CCT + UM vs. oxy (IV) + CCT + UM (ref): OR = 0.83, 95% CI 0.64-1.07.
**Anemia was defined as pre-delivery hemoglobin of < 11.0 g/dL.