| Title |
Risk factors for severe postpartum hemorrhage: a case-control study
|
|---|---|
| Published in |
BMC Pregnancy and Childbirth, January 2017
|
| DOI | 10.1186/s12884-016-1217-0 |
| Pubmed ID | |
| Authors |
Lill Trine Nyfløt, Irene Sandven, Babill Stray-Pedersen, Silje Pettersen, Iqbal Al-Zirqi, Margit Rosenberg, Anne Flem Jacobsen, Siri Vangen |
| Abstract |
In high-income countries, the incidence of severe postpartum hemorrhage (PPH) has increased. This has important public health relevance because severe PPH is a leading cause of major maternal morbidity. However, few studies have identified risk factors for severe PPH within a contemporary obstetric cohort. We performed a case-control study to identify risk factors for severe PPH among a cohort of women who delivered at one of three hospitals in Norway between 2008 and 2011. A case (severe PPH) was classified by an estimated blood loss ≥1500 mL or the need for blood transfusion for excessive postpartum bleeding. Using logistic regression, we applied a pragmatic strategy to identify independent risk factors for severe PPH. Among a total of 43,105 deliveries occurring between 2008 and 2011, we identified 1064 cases and 2059 random controls. The frequency of severe PPH was 2.5% (95% confidence interval (CI): 2.32-2.62). The most common etiologies for severe PPH were uterine atony (60%) and placental complications (36%). The strongest risk factors were a history of severe PPH (adjusted OR (aOR) = 8.97, 95% CI: 5.25-15.33), anticoagulant medication (aOR = 4.79, 95% CI: 2.72-8.41), anemia at booking (aOR = 4.27, 95% CI: 2.79-6.54), severe pre-eclampsia or HELLP syndrome (aOR = 3.03, 95% CI: 1.74-5.27), uterine fibromas (aOR = 2.71, 95% CI: 1.69-4.35), multiple pregnancy (aOR = 2.11, 95% CI: 1.39-3.22) and assisted reproductive technologies (aOR = 1.88, 95% CI: 1.33-2.65). Based on our findings, women with a history of severe PPH are at highest risk of severe PPH. As well as other established clinical risk factors for PPH, a history of severe PPH should be included as a risk factor in the development and validation of prediction models for PPH. |
Mendeley readers
The data shown below were compiled from readership statistics for 538 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 538 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 85 | 16% |
| Student > Master | 64 | 12% |
| Student > Postgraduate | 46 | 9% |
| Researcher | 34 | 6% |
| Student > Ph. D. Student | 22 | 4% |
| Other | 77 | 14% |
| Unknown | 210 | 39% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 176 | 33% |
| Nursing and Health Professions | 86 | 16% |
| Social Sciences | 8 | 1% |
| Biochemistry, Genetics and Molecular Biology | 7 | 1% |
| Agricultural and Biological Sciences | 7 | 1% |
| Other | 38 | 7% |
| Unknown | 216 | 40% |
Attention Score in Context
This research output has an Altmetric Attention Score of 12. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 31 March 2022.
All research outputs
#2,999,522
of 24,920,664 outputs
Outputs from BMC Pregnancy and Childbirth
#822
of 4,646 outputs
Outputs of similar age
#58,298
of 432,662 outputs
Outputs of similar age from BMC Pregnancy and Childbirth
#19
of 69 outputs
Altmetric has tracked 24,920,664 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,646 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.2. This one has done well, scoring higher than 82% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 432,662 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 86% of its contemporaries.
We're also able to compare this research output to 69 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 73% of its contemporaries.