Factors associated with severe postpartum haemorrhage: systematic review using Bradford Hill’s causality framework
# Background Severe postpartum haemorrhage (S-PPH) is the leading cause of maternal death worldwide. We aimed to provide an up-to-date summary about S-PPH determinants. # Methods We performed a systematic review following the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRI...
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| Format: | Article |
| Language: | English |
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Inishmore Laser Scientific Publishing Ltd
2019-12-01
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| Series: | Journal of Global Health Reports |
| Online Access: | https://doi.org/10.29392/joghr.3.e2019085 |
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| author | Tatiana Stachetti Michel Spodenkiewicz Arnaud Winer Malik Boukerrou Julie Jesson Patrick Gérardin |
| author_facet | Tatiana Stachetti Michel Spodenkiewicz Arnaud Winer Malik Boukerrou Julie Jesson Patrick Gérardin |
| author_sort | Tatiana Stachetti |
| collection | DOAJ |
| description | # Background
Severe postpartum haemorrhage (S-PPH) is the leading cause of maternal death worldwide. We aimed to provide an up-to-date summary about S-PPH determinants.
# Methods
We performed a systematic review following the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines. We searched the terms "risk factor", "determinant", "post-partum haemorrhage" and "severe", within Web of Science, Scopus, Science Direct, Medline, Cochrane, and Clinical Trials.gov databases. The primary endpoint was S-PPH, defined as a blood loss ≥1,000 mL a second-line treatment, a PPH-related blood transfusion, a peripartum decrease in haemoglobin level or a PPH-related maternal death. All interventional and observational studies about risks factors for S-PPH published in English or French between January 1, 2004 and August 31, 2018 were eligible. Because studies used very different definitions of S-PPH, meta-analysis was ruled out and we gauged the risk factors using the Bradford Hill\'s criteria causality framework.
# Results
Amongst 1,193 identified abstracts, we selected fourteen studies that collected information on 9,271,519 parturient women (35,825 with S-PPH). Key established determinants of S-PPH were previous PPH, previous caesarean, multiple pregnancy, abnormal placentation, preeclampsia, labour induction, prolonged labour, placental retention, uterine rupture, uterine atony, uterine fibroids, macrosomia, birth canal injuries, instrumental vaginal and caesarean deliveries. Most of associated factors of uncertain significance belonged to socio-environmental characteristics. Biological parameters were all classified as indicators of risk.
# Conclusions
The key established determinants of S-PPH are of primarily obstetrical nature. New avenues of research, including contextual studies, are needed to improve the management of severe obstetrical morbidity. |
| format | Article |
| id | doaj-art-163fc4b1a74e48cebe06bba4b1bac4bb |
| institution | DOAJ |
| issn | 2399-1623 |
| language | English |
| publishDate | 2019-12-01 |
| publisher | Inishmore Laser Scientific Publishing Ltd |
| record_format | Article |
| series | Journal of Global Health Reports |
| spelling | doaj-art-163fc4b1a74e48cebe06bba4b1bac4bb2025-08-20T02:39:26ZengInishmore Laser Scientific Publishing LtdJournal of Global Health Reports2399-16232019-12-01310.29392/joghr.3.e2019085Factors associated with severe postpartum haemorrhage: systematic review using Bradford Hill’s causality frameworkTatiana StachettiMichel SpodenkiewiczArnaud WinerMalik BoukerrouJulie JessonPatrick Gérardin# Background Severe postpartum haemorrhage (S-PPH) is the leading cause of maternal death worldwide. We aimed to provide an up-to-date summary about S-PPH determinants. # Methods We performed a systematic review following the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines. We searched the terms "risk factor", "determinant", "post-partum haemorrhage" and "severe", within Web of Science, Scopus, Science Direct, Medline, Cochrane, and Clinical Trials.gov databases. The primary endpoint was S-PPH, defined as a blood loss ≥1,000 mL a second-line treatment, a PPH-related blood transfusion, a peripartum decrease in haemoglobin level or a PPH-related maternal death. All interventional and observational studies about risks factors for S-PPH published in English or French between January 1, 2004 and August 31, 2018 were eligible. Because studies used very different definitions of S-PPH, meta-analysis was ruled out and we gauged the risk factors using the Bradford Hill\'s criteria causality framework. # Results Amongst 1,193 identified abstracts, we selected fourteen studies that collected information on 9,271,519 parturient women (35,825 with S-PPH). Key established determinants of S-PPH were previous PPH, previous caesarean, multiple pregnancy, abnormal placentation, preeclampsia, labour induction, prolonged labour, placental retention, uterine rupture, uterine atony, uterine fibroids, macrosomia, birth canal injuries, instrumental vaginal and caesarean deliveries. Most of associated factors of uncertain significance belonged to socio-environmental characteristics. Biological parameters were all classified as indicators of risk. # Conclusions The key established determinants of S-PPH are of primarily obstetrical nature. New avenues of research, including contextual studies, are needed to improve the management of severe obstetrical morbidity.https://doi.org/10.29392/joghr.3.e2019085 |
| spellingShingle | Tatiana Stachetti Michel Spodenkiewicz Arnaud Winer Malik Boukerrou Julie Jesson Patrick Gérardin Factors associated with severe postpartum haemorrhage: systematic review using Bradford Hill’s causality framework Journal of Global Health Reports |
| title | Factors associated with severe postpartum haemorrhage: systematic review using Bradford Hill’s causality framework |
| title_full | Factors associated with severe postpartum haemorrhage: systematic review using Bradford Hill’s causality framework |
| title_fullStr | Factors associated with severe postpartum haemorrhage: systematic review using Bradford Hill’s causality framework |
| title_full_unstemmed | Factors associated with severe postpartum haemorrhage: systematic review using Bradford Hill’s causality framework |
| title_short | Factors associated with severe postpartum haemorrhage: systematic review using Bradford Hill’s causality framework |
| title_sort | factors associated with severe postpartum haemorrhage systematic review using bradford hill s causality framework |
| url | https://doi.org/10.29392/joghr.3.e2019085 |
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