Maternal risk factors for peripartum transfusion
Deborah B Ehrenthal1, Melanie L Chichester, Oluwaseun Suzanne Cole
1Department of Obstetrics and Gynecology, Christiana Care Health System, Newark, DE 19718, USA. dehrenthal@christianacare.org
Journal of Women'S Health (2002)
|April 17, 2012
Summary
Maternal anemia and cesarean delivery significantly increase the risk of postpartum transfusion. Addressing anemia before and between pregnancies can reduce transfusion rates.
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Transfusion Medicine
Background:
- Postpartum hemorrhage is a major maternal complication in the US.
- Peripartum transfusion is the most common morbidity associated with postpartum hemorrhage.
Purpose of the Study:
- To investigate maternal and obstetric factors associated with peripartum transfusion.
- To identify modifiable risk factors for transfusion in childbearing women.
Main Methods:
- Retrospective cohort study of 59,282 deliveries between 2000-2008.
- Excluded women with coagulopathy; analyzed data from institutional data warehouse.
- Used logistic regression to explore associations between factors and transfusion odds.
Main Results:
- Transfusion incidence was 10.4/1,000 deliveries, higher in Black women.
- Anemia (hemoglobin <9.5 g/dL) increased transfusion odds by 12.65 times.
- Cesarean delivery increased transfusion odds by 4.28 times; anemia and cesarean delivery had synergistic effects.
- Anemia accounted for an estimated 31.7% of transfusions; racial disparities were explained by anemia.
Conclusions:
- Antenatal anemia and cesarean delivery are key modifiable risk factors for transfusion.
- Focusing on anemia in preconception and interconception care is crucial.
- Addressing anemia can reduce transfusion risks and improve maternal outcomes.
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