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A Swedish register-based study exploring primary postpartum hemorrhage in 405 936 full term vaginal births between
Li Thies-Lagergren1, Linda J Kvist2, Karin Gottvall3
1Department of Midwifery Research - Reproductive, Perinatal and Sexual Health, Lund University, Sweden; Department of Obstetrics and Gynaecology, Helsingborg Lasarett, Sweden.
European Journal of Obstetrics, Gynecology, and Reproductive Biology
|January 15, 2021
Summary
Postpartum hemorrhage risk remains high after vaginal birth in Sweden. First-time mothers, older age, and obesity increase risk, while grand multiparity does not. Accurate diagnosis coding is crucial for improving care.
Area of Science:
- Obstetrics and Gynecology
- Reproductive Health
- Public Health Research
Background:
- Postpartum hemorrhage (PPH) remains a significant complication following vaginal birth.
- Understanding risk factors is crucial for improving maternal outcomes and healthcare quality.
- Swedish birth data provides a valuable resource for studying PPH trends and associations.
Purpose of the Study:
- To investigate the incidence of diagnosed postpartum hemorrhage (PPH) after term vaginal birth in Sweden between 2005 and 2015.
- To analyze the relationship between socio-demographic, obstetric factors, and PPH diagnoses.
- To identify key risk factors associated with PPH in a contemporary Swedish setting.
Main Methods:
- A register-based cohort study utilizing data from The Swedish Medical Birth Register (2005-2015).
- Comparison of 52,367 PPH cases with 353,569 controls, identified via ICD-10 code O72.
- Calculation of odds ratios for maternal characteristics to determine explanatory variables for PPH.
Main Results:
- No statistically significant decrease in PPH diagnoses was observed during the study period.
- Primiparity was associated with the highest PPH risk; risk decreased with increasing parity.
- Increased maternal age (>35 years), obesity (BMI >30), and induction of labor were linked to higher PPH odds.
- Incomplete documentation of known PPH risk factors was noted in the register.
Conclusions:
- Despite care improvements, PPH remains a risk for women giving birth vaginally in Sweden.
- Primiparity, advanced maternal age, and obesity are confirmed risk factors requiring further investigation.
- Accurate and complete documentation of PPH diagnoses in birth records is essential for improving intrapartum care and reducing incidence.
