[OBESITY AS A RISK FACTOR FOR MASSIVE POSTPARTUM HEMORRHAGE.]

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Public Health

Background:

• Limited research exists on the specific impact of obesity on obstetric hemorrhage.
• Recent studies highlight the need for multivariate analysis to understand complex risk factors in childbirth complications.
• Obesity's role as an independent risk factor for severe obstetric bleeding requires thorough investigation.

Purpose of the Study:

• To evaluate the significance of obesity as an independent risk factor for severe obstetric hemorrhage.
• To determine the independent contribution of obesity to massive postpartum blood loss.
• To analyze the interplay of obesity with other factors influencing obstetric hemorrhage outcomes.

Main Methods:

• Retrospective cohort study involving 24,634 women.
• Comparison of outcomes between obese women and a control group with normal body mass index (BMI).
• Multivariate statistical analysis, including cluster analysis and regression, to assess risk factors.

Main Results:

• Obesity alone showed a minimal OR of 1.18 (CI: 0.78-1.27, p > 0.05) for massive blood loss.
• A combination of obesity, somatic pathology, and labor induction presented a significant OR of 8.57 (CI: 6.13-36.28, p < 0.001).
• Other significant risk factors included fetal macrosomia, multiple pregnancy, and operative delivery.

Conclusions:

• Obesity is not an independent risk factor for massive obstetric hemorrhage.
• Obesity acts as a significant potentiating factor when combined with other risk factors.
• Multivariate analysis is crucial for understanding the complex etiology of obstetric hemorrhage.