Table 4. Risk of type specific postpartum hemorrhage (PPH>500ml) in the second delivery according to PPH types in the first delivery and pregnancy- and birth characteristic; singleton births, ≥22 weeks of gestation and spontaneous onset or induction of labor.
| Type of PPH in second delivery | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Type of PPH in first delivery and pregnancy/birth related exposures | Total | Retained placenta | Atony | Trauma or laceration | Dystocia | Undefined bleeding cause | |||||||||||||||||||||
| (n) | (n) | % | aOR | 95% CI | (n) | % | aOR | 95% CI | (n) | % | aOR | 95% CI | (n) | % | aOR | 95% CI | (n) | % | aOR | 95% CI | |||||||
| Retained placenta | No | 785902 | 9107 | 1.2 | 1 | Ref | 19178 | 2.4 | 1 | Ref | 5795 | 0.7 | 1 | Ref | 4811 | 0.6 | 1 | Ref | 30674 | 3.9 | 1 | Ref | |||||
| Yes | 8788 | 734 | 8.4 | 5.90 | 5.45 | 6.39 | 729 | 8.3 | 2.93 | 2.71 | 3.17 | 155 | 1.8 | 1.77 | 1.50 | 2.08 | 132 | 1.5 | 1.56 | 1.31 | 1.86 | 841 | 9.6 | 1.94 | 1.80 | 2.09 | |
| Atony | No | 773349 | 8950 | 1.2 | 1 | Ref | 17745 | 2.3 | 1 | Ref | 5517 | 0.7 | 1 | Ref | 4612 | 0.6 | 1 | Ref | 29601 | 3.8 | 1 | Ref | |||||
| Yes | 21341 | 891 | 4.2 | 2.91 | 2.71 | 3.13 | 2162 | 10.1 | 4.00 | 3.82 | 4.20 | 433 | 2.0 | 2.15 | 1.95 | 2.37 | 331 | 1.6 | 1.77 | 1.58 | 1.98 | 1914 | 9.0 | 1.90 | 1.81 | 1.99 | |
| Trauma or laceration | No | 783198 | 9475 | 1.2 | 1 | Ref | 19031 | 2.4 | 1 | Ref | 5513 | 0.7 | 1 | Ref | 4855 | 0.6 | 1 | Ref | 30415 | 3.9 | 1 | Ref | |||||
| Yes | 11492 | 366 | 3.2 | 2.01 | 1.81 | 2.24 | 876 | 7.6 | 2.65 | 2.47 | 2.85 | 437 | 3.8 | 3.86 | 3.49 | 4.27 | 88 | 0.8 | 0.77 | 0.63 | 0.96 | 1100 | 9.6 | 1.89 | 1.77 | 2.02 | |
| Dystocia | No | 780869 | 9251 | 1.2 | 1 | Ref | 18800 | 2.4 | 1 | Ref | 5498 | 0.7 | 1 | Ref | 4080 | 0.5 | 1 | Ref | 29915 | 3.8 | 1 | Ref | |||||
| Yes | 13821 | 590 | 4.3 | 2.44 | 2.24 | 2.66 | 1107 | 8.0 | 2.58 | 2.42 | 2.75 | 452 | 3.3 | 2.98 | 2.70 | 3.29 | 863 | 6.2 | 6.81 | 6.31 | 7.36 | 1600 | 11.6 | 2.09 | 1.98 | 2.21 | |
| Undefined bleeding cause | No | 764798 | 9082 | 1.2 | 1 | Ref | 18281 | 2.4 | 1 | Ref | 5419 | 0.7 | 1 | Ref | 4501 | 0.6 | 1 | Ref | 28367 | 3.7 | 1 | Ref | |||||
| Yes | 29892 | 759 | 2.5 | 1.64 | 1.52 | 1.77 | 1626 | 5.4 | 1.90 | 1.80 | 2.00 | 531 | 1.8 | 1.80 | 1.64 | 1.97 | 442 | 1.5 | 1.62 | 1.46 | 1.79 | 3148 | 10.5 | 2.21 | 2.12 | 2.30 | |
| Inter-delivery interval (year) | <1 | 3433 | 56 | 1.6 | 2.00 | 1.53 | 2.62 | 64 | 1.9 | 0.90 | 0.70 | 1.15 | 10 | 0.3 | 0.57 | 0.31 | 1.07 | 12 | 0.3 | 1.14 | 0.64 | 2.02 | 118 | 3.4 | 1.01 | 0.84 | 1.22 |
| 1 to <2 | 151853 | 1815 | 1.2 | 1.08 | 1.01 | 1.14 | 3723 | 2.5 | 0.99 | 0.95 | 1.03 | 1001 | 0.7 | 0.92 | 0.86 | 1.00 | 809 | 0.5 | 1.00 | 0.91 | 1.09 | 5905 | 3.9 | 0.98 | 0.85 | 1.02 | |
| 2 to <3 | 239848 | 2924 | 1.2 | 1 | Ref | 6255 | 2.6 | 1 | Ref | 1906 | 0.8 | 1 | Ref | 1507 | 0.6 | 1 | Ref | 9898 | 4.1 | 1 | Ref | ||||||
| 3 to <4 | 166293 | 2118 | 1.3 | 1.08 | 1.02 | 1.15 | 4208 | 2.5 | 1.01 | 0.97 | 1.05 | 1319 | 0.8 | 1.05 | 0.98 | 1.12 | 968 | 0.6 | 0.98 | 0.91 | 1.07 | 6578 | 4.0 | 1.01 | 0.98 | 1.05 | |
| 4 to <5 | 88863 | 1046 | 1.2 | 1.02 | 0.95 | 1.10 | 2128 | 2.4 | 0.97 | 0.92 | 1.02 | 627 | 0.7 | 0.96 | 0.88 | 1.05 | 557 | 0.6 | 1.10 | 1.00 | 1.21 | 3364 | 3.8 | 1.01 | 0.97 | 1.05 | |
| ≥5 | 144400 | 1882 | 1.3 | 1.00 | 0.94 | 1.06 | 3529 | 2.4 | 0.93 | 0.89 | 0.97 | 1087 | 0.8 | 0.95 | 0.88 | 1.02 | 1090 | 0.8 | 1.10 | 1.02 | 1.19 | 5652 | 3.9 | 1.00 | 0.96 | 1.03 | |
| Change of father a | No | 713133 | 8704 | 1.2 | 1 | Ref | 17912 | 2.5 | 1 | Ref | 5351 | 0.8 | 1 | Ref | 4303 | 0.6 | 1 | Ref | 28160 | 3.9 | 1 | Ref | |||||
| Yes | 69371 | 981 | 1.4 | 1.00 | 0.94 | 1.07 | 1676 | 2.4 | 0.86 | 0.81 | 0.90 | 515 | 0.7 | 0.88 | 0.80 | 0.96 | 516 | 0.7 | 1.02 | 0.93 | 1.12 | 2808 | 4.0 | 0.93 | 0.90 | 0.97 | |
| Previous cesarean b | No | 743587 | 8893 | 1.2 | 1 | Ref | 18127 | 2.4 | 1 | Ref | 4518 | 0.6 | 1 | Ref | 2270 | 0.3 | 1 | Ref | 27723 | 3.7 | 1 | Ref | |||||
| Yes | 65619 | 1312 | 2.0 | 1.35 | 1.28 | 1.44 | 2368 | 3.6 | 1.28 | 1.23 | 1.34 | 1929 | 2.9 | 4.00 | 3.79 | 4.23 | 3368 | 5.1 | 13.16 | 12.46 | 13.89 | 5125 | 7.8 | 1.84 | 1.78 | 1.90 | |
CI confidence interval, aOR OR adjusted for maternal age, parity and period (1967–1977, 1978–1987, 1988–1997, 1998–2007 and 2008–2017).
a 12186 births with unknown father in 1st or 2nd delivery.
b First deliveries starting with cesarean section included.