Table 1.
Comparison of peripartal outcome and risk factors for peripartum hemorrhage from 1998–2011 and 2012–2016 (SD standard deviation, ICU intensive care unit, RBC red blood cell, Hb hemoglobin)
| Total N = 627,921 | 1998–2011 | 2012–2016 | Odds ratio (95% CI) | p value |
|---|---|---|---|---|
| N = 453,463 | N = 173,458 | |||
| Mean maternal age (years) ± SD | 30.0 ± 5.0 | 31.0 ± 4.9 | < 0.001 | |
| Mean length of stay (days) | 5.4 | 4.6 | ||
| Mean gestational age (weeks) ± SD | 39 1/7 ± 18 days | 39 1/7 ± 18 days | < 0.001 | |
| Mean birth weight (g) ± SD | 3349 ± 504 | 3330 ± 507 | < 0.001 | |
| Required ICU visit | 1194 (0.3%) | 676 (0.4%) | 1.48 (1.35–1.63) | < 0.001 |
| Peripartum (acute phase) | ||||
| Intraoperative blood loss 500–1000 ml | 40,842 (9.0%) | 22,975 (13.2%) | 1.54 (1.52–1.57) | < 0.001 |
| Intraoperative blood loss > 1000 ml | 5149 (1.1%) | 3716 (2.1%) | 1.91 (1.83–1.99) | < 0.001 |
| Peripartum RBC units (acute) | ||||
| Intraoperative 1–2 RBC units | 913 (0.2%) | 444 (0.3%) | 1.27 (1.13–1.43) | < 0.001 |
| Intraoperative > 2 RBC units | 730 (0.2%) | 250 (0.1%) | 0.90 (0.77–1.04) | 0.134 |
| Postoperative 1–2 RBC units | 880 (0.2%) | 425 (0.2%) | 1.26 (1.12–1.42) | < 0.001 |
| Postoperative > 2 RBC units | 558 (0.1%) | 180 (0.1%) | 0.84 (0.71–1.00) | 0.048 |
| Hospital stay after birth (subacute) | ||||
| Hb < 100 g/l | 26,431 (5.8%) | 5274 (3.0%) | 0.51 (0.49–0.52) | < 0.001 |
| RBC units (subacute) | ||||
| 1–2 RBC units | 1871 (0.4%) | 953 (0.5%) | 1.33 (1.23–1.44) | < 0.001 |
| 3 RBC units or more | 1184 (0.3%) | 400 (0.2%) | 0.88 (0.79–0.99) | 0.033 |
| Possible risk factors | ||||
| Retained placental products | 8744 (1.9%) | 4014 (2.3%) | 1.20 (1.16–1.25) | < 0.001 |
| Placenta previa | 1275 (0.3%) | 654 (0.4%) | 1.34 (1.22–1.48) | < 0.001 |
| Uterine rupture | 129 (0.0%) | 84 (0.0%) | 1.70 (1.28–2.26) | < 0.001 |
| Previous Cesarean section | 47,646 (10.5%) | 24,409 (14.1%) | 1.39 (1.37–1.42) | < 0.001 |
| Multiple gestation delivery | 6208 (1.4%) | 3100 (1.8%) | 1.31 (1.25–1.37) | < 0.001 |
| Induction of labor | 91,335 (20.1%) | 36,864 (21.3%) | 1.07 (1.06–1.08) | < 0.001 |
| Prolonged labor | 27,181 (6.0%) | 10,891 (6.3%) | 1.05 (1.03–1.08) | < 0.001 |
| Polyhydramnios | 2689 (0.6%) | 1698 (1.0%) | 1.66 (1.56–1.76) | < 0.001 |
| Amniotic infection syndrome | 1026 (0.2%) | 521 (0.3%) | 1.33 (1.19–1.48) | < 0.001 |
| Primary uterine inertia | 135,248 (29.8%) | 46,106 (26.6%) | 0.85 (0.84–0.86) | < 0.001 |
| Placenta accreta/increta/percreta | 1558 (0.3%) | 593 (0.3%) | 1.00 (0.90–1.10) | 0.942 |
| Placental abruption | 1315 (0.3%) | 464 (0.3%) | 0.92 (0.83–1.03) | 0.137 |
| Pre-eclampsia | 5673 (1.3%) | 2310 (1.3%) | 1.07 (1.01–1.12) | 0.011 |
| Low-lying placenta | 1635 (0.4%) | 648 (0.4%) | 1.04 (0.94–1.14) | 0.439 |