Predictors of Postpartum Hemorrhage and Associated Outcomes at a Midwest Academic Medical Center

Megan Mooberry; Natalie Voss; Linder Wendt; Kimberly A. Kenne; J. Brooks Jackson; Mary B. Rysavy

doi:10.1089/WHR.2023.0192

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Predictors of Postpartum Hemorrhage and Associated Outcomes at a Midwest Academic Medical Center

Journal article

Open access

Peer reviewed

Predictors of Postpartum Hemorrhage and Associated Outcomes at a Midwest Academic Medical Center

Megan Mooberry, Natalie Voss, Linder Wendt, Kimberly A. Kenne, J. Brooks Jackson and Mary B. Rysavy

Women's health reports (New Rochelle, N.Y.), Vol.5(1), pp.358-366

04/01/2024

DOI: 10.1089/WHR.2023.0192

PMCID: PMC11257117

PMID: 39035139

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Abstract

Background: Postpartum hemorrhage (PPH) remains a significant cause of maternal morbidity and mortality around the world, with rates increasing in the United States. The objective of this study was to determine predictors of, and outcomes associated with, PPH at a Midwest academic health center. Methods: Demographic and clinical data were obtained from the electronic medical record on all consecutive delivering patients between May 1, 2020, and April 30, 2021. Associations between PPH and perinatal characteristics and outcomes were assessed using logistic regression models. A significance threshold of 0.05 was used for all comparisons. Results: Of the 2497 delivering patients during the study period, 437 (18%) experienced PPH. Chronic hypertension, gestational hypertension, and preeclampsia with and without severe features were all associated with increased odds of PPH (odds rations [ORs], respectively, 1.61 (95% CI:1.13?2.24, p = 0.006), 1.62 (95% CI 1.18?2.21, p = 0.003), 1.81 (95% CI 1.14?2.80, p ? 0.001), and 1.92 (95% CI 1.29?2.82, p = 0.009). There were also increased odds of PPH with type I diabetes: 2.83 (95% CI 1.45?5.30, p = 0.001), type II diabetes: 2.14 (95% CI 1.15?3.82, p = 0.012), twin delivery: 3.20 (95% CI 2.11?4.81, p ? 0.001), cesarean delivery: 5.66 (95% CI 4.53?7.09, p ? 0.001), and assisted vaginal delivery: 3.12 (95% CI1.95?4.88, p ? 0.001). Infants of mothers with PPH had high odds of NICU admission (CI = 1.34?2.07, p < 0.001) and hypoxic ischemic encephalopathy (CI = 1.64?7.14, p < 0.001). Conclusion: Our findings confirm previous literature that preexisting and pregnancy-related hypertension, diabetes mellitus, multiple gestation, cesarean delivery, and assisted vaginal delivery are important predictors of PPH. In addition, we found that neonates of mothers with PPH had more adverse outcomes. These results may help to inform clinical care as rates of PPH continue to rise in the United States.

Hypertension

obstetrics

postpartum hemorrhage

pregnancy-induced

Details

Title: Subtitle: Predictors of Postpartum Hemorrhage and Associated Outcomes at a Midwest Academic Medical Center
Creators: Megan Mooberry - University of Iowa
Natalie Voss - University of Iowa
Linder Wendt - University of Iowa
Kimberly A. Kenne - University of Iowa
J. Brooks Jackson - University of Iowa
Mary B. Rysavy - The University of Texas Health Science Center at Houston
Resource Type: Journal article
Publication Details: Women's health reports (New Rochelle, N.Y.), Vol.5(1), pp.358-366
Publisher: Mary Ann Liebert
DOI: 10.1089/WHR.2023.0192
PMID: 39035139
PMCID: PMC11257117
eISSN: 2688-4844
Grant note: NIH: UL1TR002537
Funding for the study was partly provided by the Mark Gilbert and Karen Simmonds Research Gift Fund. This study was supported, in part, by the University of Iowa Clinical and Translational Science Award granted with funds from the NIH (UL1TR002537).
Language: English
Date published: 04/01/2024
Academic Unit: Pathology; Obstetrics and Gynecology
Record Identifier: 9984621360202771

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