Risk factors for blood component therapy in parturients-Case-control study

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Maternal Health

Background:

• Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality worldwide.
• Early identification of parturients at risk for severe PPH and the need for major transfusion is critical for improving outcomes.
• Understanding specific risk factors can guide preventative strategies and resource allocation.

Purpose of the Study:

• To identify and assess independent risk factors associated with the need for major transfusion in the postpartum period.
• To evaluate the association between antenatal anemia, retained placenta, and other potential factors with major postpartum transfusions.

Main Methods:

• A case-control study was conducted from 2011 to 2019, including 187,424 deliveries.
• Cases were women requiring major postpartum transfusion; controls were women not requiring transfusion or requiring 1-2 units of packed red blood cells.
• Multivariable conditional logistic regression was used to analyze independent risk factors, matching for multiple pregnancies and prior cesarean sections.

Main Results:

• 246 (0.3%) women required major transfusions.
• Independent risk factors identified included antenatal anemia (hemoglobin < 10 g/dL) (OR 12.58), retained placenta (OR 5.5), and cesarean delivery (OR 10.12).
• Maternal age was also a factor, though not statistically significant in this analysis (OR 1.07).

Conclusions:

• Antenatal anemia (hemoglobin < 10 g/dL) and retained placenta are significant independent risk factors for major postpartum transfusion.
• Antenatal anemia emerged as the most potent risk factor among those identified.
• These findings underscore the importance of managing anemia in pregnancy to reduce severe postpartum hemorrhage complications.