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A Swedish register-based study exploring primary postpartum hemorrhage in 405 936 full term vaginal births between 2005 and 2015
Open accessAbstract
OBJECTIVE: To explore diagnoses of postpartum haemorrhage following vaginal birth, in relation to socio-demographic and obstetrical data from women who gave birth at term, in Sweden, during the years 2005-2015. STUDY DESIGN: A register-based cohort study was carried out, describing and comparing socio-demographic variables, obstetric variables and infant variables in 52 367 cases of diagnosed postpartum haemorrhage compared to 353 569 controls without a postpartum haemorrhage diagnosis. Postpartum hemorrhage was identified in The Swedish Medical Birth Register by ICD-10 code O72. Variables for maternal characteristics were dichotomized and used to calculate odds ratios to find possible explanatory variables for postpartum haemorrhage. RESULTS: Between 2005 and 2015 there was no statistically significant decrease in diagnoses of postpartum haemorrhage after vaginal birth at term. Primiparity was associated with the highest risk and women birthing their fifth or subsequent child were associated with the lowest risk of postpartum hemorrhage. Increased maternal age (> 35 years) and/or obesity (BMI > 30) were associated with higher odds of postpartum haemorrhage. The risk of postpartum hemorrhage was 55 % higher when vaginal birth followed induction as compared to vaginal birth after spontaneous onset. Some of the factors known to be associated with postpartum haemorrhage were poorly documented in The Swedish Medical Birth Register. CONCLUSIONS: Birthing women in a Swedish contemporary setting are, despite efforts to improve care, still at risk of birth being complicated by postpartum haemorrhage. Primiparity, increasing maternal age and/or obesity are found to provoke an increased risk and the reasons for these findings need to be further investigated. However, grand multi-parity did not increase the risk for postpartum hemorrhage. Codes for diagnoses require correct documentation in the birth records: only when local statistics are sound and correctly reported can intrapartum care be improved, and the incidence of postpartum haemorrhage reduced.
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“Obesity is one of the key risk factors for post‐partum haemorrhage.”
From Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review (2022) · cites this paper as [92]
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“Greater risk of blood loss exceeding 1 litre in the 2 h after birth was seen in women with BMI > 25 kg m–2. 92”
From Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review (2022) · cites this paper as [92]
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- Dahlke, 2015, Prevention and management of postpartum hemorrhage: a comparison of 4 national guidelines, Obstet Gynecol, 213, 76
- Carroll, 2016, The prevalence of women’s emotional and physical health problems following a postpartum haemorrhage: a systematic review, BMC Pregnancy Childbirth, 16, 10.1186/s12884-016-1054-1 · DOI
- Thompson, 2010, Women’s breastfeeding experiences following a significant primary postpartum haemorrhage: a multicentre cohort study, Int Breastfeed J, 5, 5, 10.1186/1746-4358-5-5 · DOI
- Marshall, 2017, The impact of postpartum hemorrhage on hospital length of stay and inpatient mortality: a national inpatient sample–based analysis, Obstet Gynecol, 217, 344
- Munk-Jørgensen, 1999, Implementation of ICD-10 in the nordic countries, Nord J Psychiatry, 53, 5, 10.1080/080394899426648 · DOI
- Mousa, 2014, Treatment for primary postpartum haemorrhage, Cochrane Database Syst Rev
- Colmorn, 2015, The Nordic Obstetric Surveillance Study: a study of complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery, Acta Obstet Gynecol Scand, 94, 734, 10.1111/aogs.12639 · DOI
- Lindgren, 2014, Praxis and guidelines for planned homebirths in the Nordic countries - an overview, Sex Reprod Healthc, 5, 3, 10.1016/j.srhc.2013.12.002 · DOI
- Ludvigsson, 2011, External review and validation of the Swedish national inpatient register, BMC Public Health, 11, 10.1186/1471-2458-11-450 · DOI · Paper page
- Rydahl, 2019, Effects of induction of labor prior to post-term in low-risk pregnancies: a systematic review, JBI Database System Rev Implement Rep, 17, 170, 10.11124/JBISRIR-2017-003587 · DOI
- Brinsden, 1978, Postpartum haemorrhage after induced and spontaneous labour, Br Med J, 2, 855, 10.1136/bmj.2.6141.855 · DOI
- Durmaz, 2018, Relationship between maternal characteristics and postpartum hemorrhage: a meta-analysis study, J Nurs Res, 26, 362, 10.1097/jnr.0000000000000245 · DOI
- Ryan, 2019, Effects of parity on human myometrial response to oxytocin and ergometrine in vitro, Obstet Gynecol, 220
- Tracy, 2007, Birth outcomes associated with interventions in labour amongst low risk women: a population-based study, Women Birth, 20, 41, 10.1016/j.wombi.2007.03.005 · DOI
- Blomberg, 2014, Impact of maternal age on obstetric and neonatal outcome with emphasis on primiparous adolescents and older women: a Swedish Medical Birth Register Study, BMJ Open, 4, 10.1136/bmjopen-2014-005840 · DOI
- Mehrabadi, 2013, Epidemiological investigation of a temporal increase in atonic postpartum haemorrhage: a population‐based retrospective cohort study, Bjog Int J Obstet Gynaecol, 120, 853, 10.1111/1471-0528.12149 · DOI
- Babinszki, 1999, Perinatal outcome in grand and great-grand multiparity: effects of parity on obstetric risk factors, Am J Obstet Gynecol, 181, 669, 10.1016/S0002-9378(99)70511-9 · DOI
- Solomons, 1934, The dangerous multipara, Lancet, 224, 8, 10.1016/S0140-6736(00)90086-2 · DOI
- Blomberg, 2011, Maternal obesity and risk of postpartum hemorrhage, Obstet Gynecol, 118, 561, 10.1097/AOG.0b013e31822a6c59 · DOI
- Crankshaw, 2017, Maternal body mass index and spontaneous contractility of human myometrium in pregnancy, J Perinatol, 37, 492, 10.1038/jp.2016.271 · DOI
- Kerrigan, 2015, Obesity and normal birth: a qualitative study of clinician’s management of obese pregnant women during labour, BMC Pregnancy Childbirth, 15, 256, 10.1186/s12884-015-0673-2 · DOI
- Lao, 2014, Advanced maternal age and postpartum hemorrhage–risk factor or red herring?, J Matern Neonatal Med, 27, 243, 10.3109/14767058.2013.807240 · DOI
- Baldvinsdóttir, 2018, Improved clinical management but not patient outcome in women with postpartum haemorrhage—an observational study of practical obstetric team training, PLoS One, 13, e0203806, 10.1371/journal.pone.0203806 · DOI
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Langley‐Evans, S. C., Pearce, J., & Ellis, S. (2022) · Journal of Human Nutrition and Dietetics · doi:10.1111/jhn.12999 · Cited by 288
Metadata
- Authors
- Thies-Lagergren, L., Kvist, L. J., Gottvall, K., & Jangsten, E.
- Affiliations
- Lund University (SE)
- National Board of Health and Welfare (SE)
- University of Gothenburg (SE)
- Venue
- European Journal of Obstetrics & Gynecology and Reproductive Biology
- Publisher
- Elsevier BV
- Published
- 2021-03
- Volume
- 258
- Pages
- 184-188
- ISSN
- 0028-2243 (ISSN-L)
- 0301-2115
- OpenAlex
- W3120991957
- Cited by
- 35
- References
- 0
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 21 · 2023: 4 · 2022: 2 · 2021: 1
- FWCI
- 6.96
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Journal of Obstetrics & Gynecology and Reproductive Biology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Hematology › Blood transfusion and management
- Keywords
- postpartum hemorrhage, vaginal delivery, term birth, primiparity, parity, maternal age, maternal obesity, labor induction, Swedish Medical Birth Register, risk factors
- MeSH terms
- Adult, Child, Female, Postpartum Hemorrhage, Humans, Maternal Age, Pregnancy, Risk Factors, Sweden, Cohort Studies
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- The paper
- Thies-Lagergren, L., Kvist, L. J., Gottvall, K., & Jangsten, E. (2021). A Swedish register-based study exploring primary postpartum hemorrhage in 405 936 full term vaginal births between 2005 and 2015. European Journal of Obstetrics & Gynecology and Reproductive Biology. https://doi.org/10.1016/j.ejogrb.2020.12.018
