Table 1.
Clinical profile of women with severe postpartum hemorrhage versus controls
| SPPH(n = 506) | Controls (n = 32,828) | OR | 95%CI | P | |
|---|---|---|---|---|---|
| Maternal age (y) | |||||
| < 18 | 1 (0.20%) | 20 (0.06%) | 3.99 | 0.53–29.84 | 0.636 |
| 18–34.9 | 318 (62.85%) | 25,389 (77.34%) | Ref. | ||
| 35–39.9 | 149 (29.45%) | 5883 (17.92%) | 2.02 | 1.66–2.46 | < 0.001 |
| ≥ 40 | 38 (7.51%) | 1536 (4.68%) | 1.98 | 1.41–2.78 | < 0.001 |
| Parity | |||||
| 0 | 138 (27.27%) | 17,913 (54.57%) | Ref. | ||
| 1–2 | 355 (70.16%) | 14,698 (44.77%) | 3.14 | 2.57–3.82 | < 0.001 |
| ≥ 3 | 13 (2.57%) | 217 (0.66%) | 7.78 | 4.34–13.95 | < 0.001 |
| Previous cesarean deliverya | 302 (81.84%) | 6323 (42.34%) | 6.14 | 4.70–8.01 | < 0.001 |
| BMI (kg/m2) | |||||
| < 18.5 | 41 (8.10%) | 3239 (9.87%) | 0.83 | 0.60–1.14 | 0.250 |
| 18.5–24.9 | 354 (69.96%) | 23,107 (70.39%) | Ref. | ||
| 25–29.9 | 91 (17.98%) | 5531 (16.85%) | 1.07 | 0.85–1.36 | 0.547 |
| ≥ 30 | 20 (3.95%) | 951 (2.90%) | 1.37 | 0.87–2.16 | 0.172 |
| History of PPHb | 20 (5.42%) | 161 (1.08%) | 5.26 | 3.27–8.47 | < 0.001 |
| Chronic hypertension | 0 (0.00%) | 79 (0.24%) | – | – | 0.519 |
| PGDM | 0 (0.00%) | 248 (0.76%) | – | – | 0.089 |
| Cardiac disease | 8 (1.58%) | 354 (1.08%) | 1.47 | 0.73–2.99 | 0.282 |
| IVF | 84 (16.60%) | 4283 (13.05%) | 1.33 | 1.05–1.68 | 0.019 |
| Irregular prenatal examination | 282 (55.73%) | 15,524 (47.29%) | 1.40 | 1.18–1.68 | < 0.001 |
| Twins | 34 (6.72%) | 2186 (6.66%) | 1.01 | 0.71–1.43 | 0.957 |
| Hypertensive disorders of pregnancy | |||||
| Gestational hypertension | 15 (2.96%) | 706 (2.15%) | 1.40 | 0.83–2.36 | 0.203 |
| Preeclampsia | 26 (5.14%) | 1422 (4.33%) | 1.21 | 0.81–1.80 | 0.356 |
| Eclampsia | 0 (0.00%) | 18 (0.05%) | – | – | 0.999 |
| HELLP syndrome | 2 (0.40%) | 68 (0.21%) | 1.91 | 0.47–7.82 | 0.669 |
| GDM | 105 (20.75%) | 5369 (16.35%) | 1.34 | 1.08–1.66 | 0.008 |
| Fibroids | 5 (0.99%) | 172 (0.52%) | 1.90 | 0.78–4.63 | 0.264 |
| Anemia | 158 (31.23%) | 2954 (9.00%) | 4.59 | 3.79–5.56 | < 0.001 |
| Thrombocytopenia | 6 (1.13%) | 317 (0.97%) | 1.23 | 0.55–2.77 | 0.785 |
| Blood coagulation disorder | 2 (0.40%) | 43 (0.13%) | 3.03 | 0.73–12.52 | 0.319 |
| Stillbirth | 7 (1.38%) | 132 (0.40%) | 3.48 | 1.62–7.47 | 0.002 |
| Induction of labor | 22 (4.35%) | 3045 (9.28%) | 0.45 | 0.29–0.68 | < 0.001 |
| Prolonged labor | 18 (3.56%) | 583 (1.78%) | 2.04 | 1.27–3.29 | 0.003 |
| Precipitate labor | 1 (0.20%) | 219 (0.67%) | 0.30 | 0.04–2.11 | 0.309 |
| Mode of delivery | |||||
| Vaginal delivery | 370 (73.12%) | 27,780 (84.62%) | Ref. | ||
| Cesarean section | 136 (26.88%) | 5408 (16.47%) | 2.02 | 1.66–2.47 | < 0.001 |
| Placenta previa | 311 (61.46%) | 1392 (4.24%) | 36.02 | 29.88–43.42 | < 0.001 |
| Placental abruption | 11 (2.17%) | 337 (1.03%) | 2.14 | 1.17–3.93 | 0.014 |
| PAS | 283 (55.93%) | 1076 (3.28%) | 37.45 | 31.10–45.09 | < 0.001 |
| Macrosomia | 41 (8.10%) | 2553 (7.78%) | 1.05 | 0.76–1.44 | 0.79 |
Data presented as n (%), odds ratio (OR) and 95% confidence intervals (CI)
Previous cesarean deliverya: nulliparous women were removed from the denominator, 302/369 (81.84%) in SPPH, and 6323/14934 (42.34%) in controls
History of PPHb: nulliparous women were removed from the denominator, 20/369 (5.42%) in SPPH, and 161/14934 (1.08%) in controls
SPPH severe postpartum hemorrhage, BMI body mass index, PGDM pre-gestational diabetes mellitus, IVF in vitro fertilization, HELLP syndrome, hemolysis elevated liver enzymes, low platelet count, GDM gestational diabetes mellitus, PAS placenta accrete spectrum