Postpartum haemorrhage in Zimbabwe: a risk factor analysis

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Epidemiology

Background:

• Postpartum hemorrhage (PPH) remains a leading cause of maternal mortality globally.
• Effective antenatal screening requires accurate identification of risk factors for PPH.
• Previous studies have identified various risk factors, but their relative importance and consistency require ongoing investigation.

Purpose of the Study:

• To identify significant risk factors associated with postpartum hemorrhage (PPH).
• To inform and enhance the effectiveness of antenatal screening protocols for PPH.
• To re-evaluate the role of previously recognized and potential new risk factors for PPH.

Main Methods:

• A population-based case-control study design was employed.
• Data were collected from medical records of women in Harare, Zimbabwe.
• Multivariate logistic regression analysis was used to estimate relative risks.

Main Results:

• Low parity, advanced maternal age (≥35 years), and antenatal hospitalization emerged as strong predictors of PPH.
• History of poor maternal or perinatal outcomes and borderline anemia at booking showed modest associations.
• No significant association was found between grand multiparity and PPH.

Conclusions:

• Findings confirm established risk factors like low parity, anemia, and poor obstetric history.
• The study questions the significance of grand multiparity as a risk factor for PPH.
• Advanced maternal age and occiput posterior head position are identified as potential predictors warranting further research.