Trends in Postpartum Hemorrhage in the United States From 2010 to 2014

Reale, Sharon C; Easter, Sarah Rae; Xu, Xinling; Bateman, Brian T.; Farber, Michaela K.

doi:10.1213/ane.0000000000004424

Cited by 103 publications

(52 citation statements)

References 17 publications

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“…Among the five studies on LENI conducted worldwide since 2002, researchers reported various incidence rates: 0.3% (Tournier et al, 2019), 0.6% (Dar et al, 2002), 0.92% (Wong et al, 2003), 0.96% (Haller et al, 2017), and 2.3% (Richard et al, 2017). These reported rates are similar to those for shoulder dystocia (0.2%-3%; American College of Obstetricians and Gynecologists Committee on Practice Bulletins-Obstetrics, 2017), postpartum venous thrombosis (0.05%-0.2%; American College of Obstetricians and Gynecologists Committee on Practice Bulletins-Obstetrics, 2018), and postpartum hemorrhage (3%; Reale et al, 2020). Notably, while these three complications are well-known and have associated evidence-based practice and training guidelines, LENI remains unfamiliar to many health care providers.…”

Section: Introductionsupporting

confidence: 69%

Lower Extremity Nerve Injury in Childbirth: AWHONN Practice Brief Number 11

Obstetric¹,

Nurses²

2020

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Section: Introductionsupporting

confidence: 69%

Lower Extremity Nerve Injury in Childbirth: AWHONN Practice Brief Number 11

Obstetric¹,

Nurses²

2020

Journal of Obstetric, Gynecologic & Neonatal Nursing

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“…In Canada, from 2001 to 2009, the incidence of PPH increased from 6.0 to 7.9% and from 1.4 to 2.7%, in vaginal deliveries and cesarean section cases, respectively (4). A nationwide study from the US also revealed that the incidence of PPH increased from 2.9 to 3.2% from 2010 to 2014 (9).Research from other countries also revealed similar results (5).…”

Section: Introductionmentioning

confidence: 81%

“…A study including 8.5 million pregnant women in the US revealed that the incidence of PPH was 2.8% in 2008 (7). In 2014, another larger study including >30 million patients reported a similar rate of 3.2% (9). In Canada, research in 2009 reported a 7.9% incidence of PPH in vaginal deliveries and 2.7% in cesarean section cases (4).…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors of Postpartum Hemorrhage in China: A Multicenter Retrospective Study

Gao

Liu

et al. 2021

Front. Med.

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Background: Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality worldwide but the incidence and its risk factors in China is limited. The objective of this study is to investigate the incidence and the risk factors of PPH in Chinese women.Methods: A multi-center retrospective study of pregnant women at ≥28 weeks of gestation was conducted. Logistic regression was used to identify potential risk factors of PPH and receiver operating characteristic curve was used to evaluate the predictive performance of the identified risk factors. Subgroup analysis focusing on the number of fetus and the mode of delivery was conducted.Results: A total of 99,253 pregnant women were enrolled and 804 (0.81%) experienced PPH. The subgroup analysis revealed that the incidence of PPH was 0.75, 2.65, 1.40, and 0.31% in singletons, twin pregnancies, cesarean sections, and vaginal deliveries, respectively. Placenta previa and placenta accreta were the predominant risk factors of PPH in the overall population and all subgroups. A twin pregnancy was a risk factor for PPH regardless of the mode of delivery. Obesity, and multiparity were risk factors for PPH in both singletons and cesarean section cases, but the latter predicted a reduced probability of PPH in vaginal deliveries. Macrosomia was associated with increased risk of PPH in singletons or vaginal deliveries. In women who delivered vaginally, preeclampsia was associated with a higher risk of PPH. The areas under the curve for the overall cohort, singletons, twin pregnancies, cesarean section cases, and vaginal deliveries were 0.832 (95% confidence interval [CI] 0.813–0.851), 0.824 (95% CI 0.803–0.845), 0.686 (95% CI 0.617–0.755), 0.854 (95% CI 0.834–0.874), and 0.690 (95% CI 0.646–0.735), respectively.Conclusions: The risk factors of PPH varied slightly based on the number of fetuses and the mode of delivery, while placenta previa and placenta accreta were the two major risk factors. A combination of the identified risk factors yielded a satisfactory predictive performance in determining PPH in the overall cohort, singletons pregnancies, and women who delivered by cesarean section, whereas the performance was moderate in twin pregnancies and in women delivering vaginally.

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“…Overall, the incidence of PPH appears to be increasing. [5][6][7] Women with postpartum uterine atony have an increased risk of obstetric morbidity. The risk of morbidity in women who experience uterine atony after cesarean delivery was increased among African American and Hispanic compared with White women, in women with multiple gestation, placenta previa, ASA Physical Status 3 or 4, exposure to general anesthesia, and multiple prior cesarean deliveries.…”

mentioning

confidence: 99%