Table 2. Distribution of maternal, pregnancy and birth characteristics in types of postpartum hemorrhage (PPH >500ml); singleton births, ≥22 weeks of gestation.
All types | Retained placenta | Atony | Trauma or laceration | Placental abruption | Placenta previa | Dystocia | Undefined bleeding cause | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
(n) | % | (n) | % | (n) | % | (n) | % | (n) | % | (n) | % | (n) | % | (n) | % | ||
Maternal age (years) | <20 | 9332 | 3.0 | 863 | 2.4 | 2523 | 3.4 | 1054 | 3.7 | 106 | 2.9 | 13 | 0.5 | 801 | 2.1 | 3972 | 3.0 |
20–24 | 55452 | 17.7 | 5711 | 16.0 | 14388 | 19.6 | 6045 | 21.1 | 576 | 16.0 | 136 | 5.4 | 5829 | 15.5 | 22767 | 17.4 | |
25–29 | 103710 | 33.2 | 11198 | 31.4 | 25115 | 34.3 | 10641 | 37.1 | 1098 | 30.5 | 513 | 20.2 | 13315 | 35.4 | 41830 | 31.9 | |
30–34 | 92251 | 29.5 | 11223 | 31.5 | 20744 | 28.3 | 7685 | 26.8 | 1086 | 30.2 | 922 | 36.4 | 11806 | 31.4 | 38785 | 29.6 | |
35–39 | 42678 | 13.7 | 5494 | 15.4 | 8802 | 12.0 | 2807 | 9.8 | 578 | 16.1 | 746 | 29.3 | 4914 | 13.1 | 19337 | 14.7 | |
40–44 | 8595 | 2.8 | 1112 | 3.1 | 1621 | 2.2 | 414 | 1.4 | 148 | 4.1 | 200 | 7.9 | 884 | 2.4 | 4216 | 3.2 | |
≥45 | 510 | 0.2 | 63 | 0.2 | 91 | 0.1 | 27 | 0.1 | 6 | 0.2 | 12 | 0.5 | 48 | 0.1 | 263 | 0.2 | |
Parity | 0 | 157617 | 50.4 | 16033 | 45.0 | 34849 | 47.6 | 18661 | 65.1 | 1290 | 35.9 | 739 | 29.1 | 28690 | 76.3 | 57355 | 43.7 |
1 | 99371 | 31.8 | 12316 | 34.5 | 24554 | 33.5 | 7485 | 26.1 | 1217 | 33.8 | 1032 | 40.6 | 6838 | 18.2 | 45929 | 35.0 | |
2 | 38856 | 12.4 | 5204 | 14.6 | 9792 | 13.4 | 1931 | 6.7 | 668 | 18.6 | 469 | 18.5 | 1511 | 4.0 | 19281 | 14.7 | |
3 | 10994 | 3.5 | 1421 | 4.0 | 2731 | 3.7 | 416 | 1.5 | 240 | 6.7 | 203 | 8.0 | 372 | 1.0 | 5611 | 4.3 | |
4 | 3983 | 1.3 | 463 | 1.3 | 928 | 1.3 | 140 | 0.5 | 128 | 3.6 | 71 | 2.8 | 135 | 0.4 | 2118 | 1.6 | |
≥5 | 1707 | 0.5 | 227 | 0.6 | 430 | 0.6 | 40 | 0.1 | 55 | 1.5 | 28 | 1.1 | 51 | 0.1 | 876 | 0.7 | |
Year of delivery | 1967–1969 | 9042 | 2.9 | 779 | 2.2 | 2268 | 3.1 | 430 | 1.5 | 155 | 4.3 | 36 | 1.4 | 182 | 0.5 | 5192 | 4.0 |
1970–1979 | 24384 | 7.8 | 2718 | 7.6 | 6836 | 9.3 | 1701 | 5.9 | 318 | 8.8 | 61 | 2.4 | 853 | 2.3 | 11897 | 9.1 | |
1980–1989 | 25760 | 8.2 | 3510 | 9.8 | 8007 | 10.9 | 3108 | 10.8 | 384 | 10.7 | 99 | 3.9 | 2157 | 5.7 | 8495 | 6.5 | |
1990–1999 | 40825 | 13.1 | 4990 | 14.0 | 11430 | 15.6 | 4559 | 15.9 | 543 | 15.1 | 230 | 9.0 | 4669 | 12.4 | 14404 | 11.0 | |
2000–2009 | 96120 | 30.8 | 12294 | 34.5 | 22990 | 31.4 | 7858 | 27.4 | 1179 | 32.8 | 1003 | 39.5 | 12572 | 33.4 | 38224 | 29.1 | |
2010–2017 | 116397 | 37.2 | 11373 | 31.9 | 21753 | 29.7 | 11017 | 38.4 | 1019 | 28.3 | 1113 | 43.8 | 17164 | 45.7 | 52958 | 40.4 | |
Previous 1st trimester spontaneous abortion a | No | 177174 | 80.4 | 19011 | 76.8 | 37367 | 80.5 | 16185 | 83.6 | 1759 | 76.5 | 1570 | 72.5 | 25314 | 82.5 | 75968 | 80.3 |
Yes | 43142 | 19.6 | 5737 | 23.2 | 9046 | 19.5 | 3181 | 16.4 | 539 | 23.5 | 597 | 27.5 | 5362 | 17.5 | 18680 | 19.7 | |
1st trimester bleeding | No | 303194 | 97.0 | 33940 | 95.2 | 71180 | 97.1 | 28130 | 98.1 | 3473 | 96.5 | 2386 | 93.9 | 36477 | 97.0 | 127608 | 97.3 |
Yes | 9334 | 3.0 | 1724 | 4.8 | 2104 | 2.9 | 543 | 1.9 | 125 | 3.5 | 156 | 6.1 | 1120 | 3.0 | 3562 | 2.7 | |
Previous cesarean section | No | 279188 | 89.3 | 32597 | 91.4 | 68194 | 93.1 | 25881 | 90.3 | 3119 | 86.7 | 2050 | 80.6 | 33216 | 88.3 | 114131 | 87.0 |
Yes | 33340 | 10.7 | 3067 | 8.6 | 5090 | 6.9 | 2792 | 9.7 | 479 | 13.3 | 492 | 19.4 | 4381 | 11.7 | 17039 | 13.0 | |
Preeclampsia | No | 299179 | 95.7 | 34182 | 95.8 | 70433 | 96.1 | 27615 | 96.3 | 3310 | 92.0 | 2502 | 98.4 | 35943 | 95.6 | 125194 | 95.4 |
Yes | 13349 | 4.3 | 1482 | 4.2 | 2851 | 3.9 | 1058 | 3.7 | 288 | 8.0 | 40 | 1.6 | 1654 | 4.4 | 5976 | 4.6 | |
Smoking in start of pregnancy a | No | 165227 | 89.1 | 18531 | 86.7 | 36750 | 89.6 | 15846 | 91.1 | 1491 | 79.1 | 158 | 43.3 | 23531 | 90.3 | 68920 | 89.2 |
Occasionally | 2880 | 1.6 | 333 | 1.6 | 604 | 1.5 | 258 | 1.5 | 52 | 2.8 | 28 | 7.7 | 405 | 1.6 | 1200 | 1.6 | |
Yes | 17275 | 9.3 | 2509 | 11.7 | 3680 | 9.0 | 1288 | 7.4 | 341 | 18.1 | 179 | 49.0 | 2117 | 8.1 | 7161 | 9.3 | |
Gestational or pregestational diabetes mellitus | No | 302981 | 96.9 | 34768 | 97.5 | 71523 | 97.6 | 28001 | 97.7 | 3510 | 97.6 | 2459 | 96.7 | 36002 | 95.8 | 126718 | 96.6 |
Yes | 9547 | 3.1 | 896 | 2.5 | 1761 | 2.4 | 672 | 2.3 | 88 | 2.4 | 83 | 3.3 | 1595 | 4.2 | 4452 | 3.4 | |
Start of delivery | Spontaneous | 216838 | 69.4 | 26006 | 72.9 | 54963 | 75.0 | 22129 | 77.2 | 1946 | 54.1 | 624 | 24.5 | 26318 | 70.0 | 84852 | 64.7 |
Induction | 66721 | 21.3 | 7342 | 20.6 | 15513 | 21.2 | 6337 | 22.1 | 815 | 22.7 | 148 | 5.8 | 11279 | 30.0 | 25287 | 19.3 | |
Cesarean section | 28969 | 9.3 | 2316 | 6.5 | 2808 | 3.8 | 207 | 0.7 | 837 | 23.3 | 1770 | 69.6 | 0 | 0.0 | 21031 | 16.0 | |
Birthweight (grams) | <4000 | 222509 | 71.2 | 26665 | 74.8 | 49843 | 68.0 | 19593 | 68.3 | 3327 | 92.5 | 2404 | 94.6 | 23258 | 61.9 | 97419 | 74.3 |
4000–4499 | 68414 | 21.9 | 6928 | 19.4 | 17788 | 24.3 | 6956 | 24.3 | 222 | 6.2 | 118 | 4.6 | 10539 | 28.0 | 25863 | 19.7 | |
4500–4999 | 18621 | 6.0 | 1803 | 5.1 | 4911 | 6.7 | 1851 | 6.5 | 41 | 1.1 | 18 | 0.7 | 3245 | 8.6 | 6752 | 5.1 | |
≥5000 | 2984 | 1.0 | 268 | 0.8 | 742 | 1.0 | 273 | 1.0 | 8 | 0.2 | 2 | 0.1 | 555 | 1.5 | 1136 | 0.9 | |
Fetal sex b | Girl | 154394 | 49.4 | 19241 | 54.0 | 37118 | 50.7 | 14021 | 48.9 | 1601 | 44.5 | 1184 | 46.6 | 16634 | 44.2 | 64595 | 49.2 |
Boy | 158114 | 50.6 | 16414 | 46.0 | 36163 | 49.3 | 14652 | 51.1 | 1997 | 55.5 | 1358 | 53.4 | 20962 | 55.8 | 66568 | 50.8 | |
Cesarean section (irrespective of start) | No | 237468 | 76.0 | 30622 | 85.9 | 65379 | 89.2 | 27751 | 96.8 | 1176 | 32.7 | 119 | 4.7 | 20995 | 55.8 | 91426 | 69.7 |
Yes | 75060 | 24.0 | 5042 | 14.1 | 7905 | 10.8 | 922 | 3.2 | 2422 | 67.3 | 2423 | 95.3 | 16602 | 44.2 | 39744 | 30.3 | |
Vacuum delivery | No | 275186 | 88.1 | 32333 | 90.7 | 66115 | 90.2 | 23458 | 81.8 | 3494 | 97.1 | 2537 | 99.8 | 22347 | 59.4 | 124902 | 95.2 |
Yes | 37342 | 11.9 | 3331 | 9.3 | 7169 | 9.8 | 5215 | 18.2 | 104 | 2.9 | 5 | 0.2 | 15250 | 40.6 | 6268 | 4.8 | |
Forceps delivery | No | 302559 | 96.8 | 34869 | 97.8 | 71598 | 97.7 | 26663 | 93.0 | 3547 | 98.6 | 2536 | 99.8 | 33700 | 89.6 | 129646 | 98.8 |
Yes | 9969 | 3.2 | 795 | 2.2 | 1686 | 2.3 | 2010 | 7.0 | 51 | 1.4 | 6 | 0.2 | 3897 | 10.4 | 1524 | 1.2 | |
Shoulder dystocia | No | 307711 | 98.5 | 35177 | 98.6 | 72058 | 98.3 | 27989 | 97.6 | 3586 | 99.7 | 2540 | 99.9 | 36558 | 97.2 | 129803 | 99.0 |
Yes | 4817 | 1.5 | 487 | 1.4 | 1226 | 1.7 | 684 | 2.4 | 12 | 0.3 | 2 | 0.1 | 1039 | 2.8 | 1367 | 1.0 | |
Episiotomy c | No | 171611 | 77.9 | 19634 | 79.3 | 35045 | 75.5 | 13164 | 68.0 | 2218 | 96.5 | 2149 | 99.2 | 19842 | 64.7 | 79559 | 84.1 |
Yes | 48705 | 22.1 | 5114 | 20.7 | 11368 | 24.5 | 6202 | 32.0 | 80 | 3.5 | 18 | 0.8 | 10834 | 35.3 | 15089 | 15.9 | |
Epidural anasthesia | No | 217383 | 69.6 | 26376 | 74.0 | 54188 | 73.9 | 19013 | 66.3 | 3101 | 86.2 | 2268 | 89.2 | 13166 | 35.0 | 99271 | 75.7 |
Yes | 95145 | 30.4 | 9288 | 26.0 | 19096 | 26.1 | 9660 | 33.7 | 497 | 13.8 | 274 | 10.8 | 24431 | 65.0 | 31899 | 24.3 | |
Placenta defined as normal c | No | 54383 | 24.7 | 18208 | 73.6 | 10490 | 22.6 | 3003 | 15.5 | 1050 | 45.7 | 714 | 32.9 | 6677 | 21.8 | 14241 | 15.0 |
Yes | 165933 | 75.3 | 6540 | 26.4 | 35923 | 77.4 | 16363 | 84.5 | 1248 | 54.3 | 1453 | 67.1 | 23999 | 78.2 | 80407 | 85.0 | |
Velamentous umbilical cord incertion c | No | 215432 | 97.8 | 23625 | 95.5 | 45476 | 98.0 | 19002 | 98.1 | 2205 | 96.0 | 2052 | 94.7 | 30159 | 98.3 | 92913 | 98.2 |
Yes | 4884 | 2.2 | 1123 | 4.5 | 937 | 2.0 | 364 | 1.9 | 93 | 4.0 | 115 | 5.3 | 517 | 1.7 | 1735 | 1.8 | |
Marginal umbilical cord incertion c | No | 206851 | 93.9 | 23027 | 93.0 | 43267 | 93.2 | 18090 | 93.4 | 2093 | 91.1 | 1949 | 89.9 | 28818 | 93.9 | 89607 | 94.7 |
Yes | 13465 | 6.1 | 1721 | 7.0 | 3146 | 6.8 | 1276 | 6.6 | 205 | 8.9 | 218 | 10.1 | 1858 | 6.1 | 5041 | 5.3 |
Incidences according to maternal, pregnancy and birth characteristics are given in Table 3.
a 1999–2017, smoking status available in 163731 deliveries with PPH.
b 18 newborns with unknown sex.
c 1999–2017.