The association between ABO blood group and obstetric hemorrhage

Abstract

descriptive, χ(2) (p < 0.05 significant) and multivariable regression models [odds ratio (OR), 95 % confidence interval (CI), p value]. 125,768 deliveries were included. After multivariable analysis, women with O blood type relative to women with non-O blood type had significantly higher odds of postpartum hemorrhage (OR 1.14; 95 % CI 1.05-1.23, p < 0.001), higher odds of statistically significant hemoglobin decreases of >2, 3, or 4 g/dL (OR 1.07; 95 % CI 1.04-1.11, p < 0.001, OR 1.08; 95 % CI 1.03-1.14, p = 0.002, OR 1.14; 95 % CI 1.05-1.23, p = 0.001; respectively), and higher odds, albeit not statistically significant of 5, 6, or 7 g/dL decreases in hemoglobin (OR 1.13; 95 % CI 1.00-1.29, p = 0.055, OR 1.05; 95 % CI 0.84-1.32, p = 0.66, OR 1.15; 95 % CI 0.79-1.68, p = 0.46; respectively), but no difference in blood products transfusion (OR 1.03; 95 % CI 0.92-1.16, p = 0.58). In conclusion, women with blood type O may be at greater risk of obstetrical hemorrhage.

Blood group O: A novel risk factor for increased postpartum blood loss?

“…Drukker et al found that a drop of haemoglobin by 20, 30 and 40 g/L after delivery was seen significantly more often in blood group O patients. 19 Further, the analysis of blood specimen which were taken 6-9 months after delivery from women enrolled in the "NOHA First cohort" revealed that low levels of VWF and blood group O carrier status were independently associated with a significant risk of severe PPH. 10 This supports our assumption that blood group O and along with it lower levels of active VWF constitutes a risk factor for increased postpartum blood loss.…”

“…Our study findings are concordant with studies that have been published previously. Drukker et al found that a drop of haemoglobin by 20, 30 and 40 g/L after delivery was seen significantly more often in blood group O patients . Further, the analysis of blood specimen which were taken 6‐9 months after delivery from women enrolled in the “NOHA First cohort” revealed that low levels of VWF and blood group O carrier status were independently associated with a significant risk of severe PPH .…”

Evaluation of blood type as a potential risk factor for early postpartum hemorrhage

“…Early PPH is defined as bleeding that occurs within 24 hours from birth, while late PPH occurs between 24 hours and 6 weeks postpartum [3]. Identifying pre-delivery risk factors allows for earlier recognition and prevention of PPH [4]. Coagulation disorders are recognized as underlying causes for PPH, with von Willebrand disease (VWD) being the most common hereditary coagulopathy associated with PPH [5].…”

The impact of blood type on transfusion after major emergency abdominal surgery

“…Though the difference in transfusion volume did not reach statistical significance, there was a tendency toward increased hemorrhage in type O patients. Similarly, increased risk of post‐partum hemorrhage with OR 1.14 ((95% CI 1.05–1.23); p < 0.001) has been observed in type O women in a retrospective study involving 125,768 deliveries, but again, no significant difference in blood product usage between O and non‐O type was found. Furthermore, a meta‐analysis from 2013, including 22 studies and 9,468 surgical and non‐surgical patients, reported an OR of 1.33 (95% CI 1.25–1.42); p < 0,001) for bleeding complication in patients with type O compared to non‐O.…”

“…Earlier studies on hemorrhage and transfusion in relation to blood type have been contradictory. A meta‐analysis of surgical and non‐surgical patients showed a significant increase in hemorrhage in patients with type O compared with non‐O, whereas there is contradictory results both for and against an increased need for transfusion in relation to surgery in patients with type O. Recently, an increased mortality due to trauma induced hemorrhage was reported in patients with type O .…”