Risk Factors and Predictive Models for Postpartum Hemorrhage after Vaginal Delivery

Background: Postpartum hemorrhage (PPH) remains one of the biggest reasons of maternal morbidity and mortality. Clinical prediction of PPH remains challenging, particularly in the case of a vaginal birth. The purpose of this research is identifying patients at risk for PPH in vagi...

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Main Authors: Yongjuan Bi, Yanhua Zhang, Li Li, Jing Bai, Jing Li
Format: Article
Language:English
Published: IMR Press 2024-09-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/51/10/10.31083/j.ceog5110221
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author Yongjuan Bi
Yanhua Zhang
Li Li
Jing Bai
Jing Li
author_facet Yongjuan Bi
Yanhua Zhang
Li Li
Jing Bai
Jing Li
author_sort Yongjuan Bi
collection DOAJ
description Background: Postpartum hemorrhage (PPH) remains one of the biggest reasons of maternal morbidity and mortality. Clinical prediction of PPH remains challenging, particularly in the case of a vaginal birth. The purpose of this research is identifying patients at risk for PPH in vaginal delivery by using risk factors and predictive models. Methods: 1840 cases who underwent vaginal deliveries at Beijing Ditan Hospital, Capital Medical University between December 2020 to December 2022, which were divided into two groups based on the amount of blood loss (PPH and non-PPH groups). Fourteen risk factors could cause increased risk of PPH, including demographic characteristics and placental anomalies factors. Logistic regression analysis was used to influence the risk factors of PPH in vaginal delivery. According to the results of multivariate logistic regression analysis, a risk prediction model was established, the Hosmer-Lemeshow test was used to assess the model fit. Results: A total of 94 cases presented with PPH in this study, and the incidence of PPH was 5.10% (94/1840). Two items including macrosomia (odds ratio (OR): 2.229, 95% confidence interval (95% CI): 1.062–4.679) and placental anomalies (OR: 4.095, 95% CI: 2.488–6.742) were independent risk factors affecting the occurrence of PPH with vaginal delivery (p < 0.05). Conclusion: The construction of a logistic regression-based model can be used to predict the risk of PPH after vaginal delivery, predictability to be studied further. Clinically, more attention should be paid to vaginal delivery, early identification and screening of high-risk factors for PPH, as well as timely preventive interventions for high-risk groups so as to reduce the risk of PPH.
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spelling doaj-art-16de7e0bc9604d1a8d50bef5669f75c42025-08-20T03:54:32ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632024-09-01511022110.31083/j.ceog5110221S0390-6663(24)02441-2Risk Factors and Predictive Models for Postpartum Hemorrhage after Vaginal DeliveryYongjuan Bi0Yanhua Zhang1Li Li2Jing Bai3Jing Li4Department of Obstetrics, Beijing Ditan Hospital, Capital Medical University, 100015 Beijing, ChinaDepartment of Intensive Care Unit, Beijing Ditan Hospital, Capital Medical University, 100015 Beijing, ChinaDepartment of Obstetrics, Beijing Ditan Hospital, Capital Medical University, 100015 Beijing, ChinaDepartment of Paediatric, Beijing Ditan Hospital, Capital Medical University, 100015 Beijing, ChinaDepartment of Obstetrics, Beijing Ditan Hospital, Capital Medical University, 100015 Beijing, ChinaBackground: Postpartum hemorrhage (PPH) remains one of the biggest reasons of maternal morbidity and mortality. Clinical prediction of PPH remains challenging, particularly in the case of a vaginal birth. The purpose of this research is identifying patients at risk for PPH in vaginal delivery by using risk factors and predictive models. Methods: 1840 cases who underwent vaginal deliveries at Beijing Ditan Hospital, Capital Medical University between December 2020 to December 2022, which were divided into two groups based on the amount of blood loss (PPH and non-PPH groups). Fourteen risk factors could cause increased risk of PPH, including demographic characteristics and placental anomalies factors. Logistic regression analysis was used to influence the risk factors of PPH in vaginal delivery. According to the results of multivariate logistic regression analysis, a risk prediction model was established, the Hosmer-Lemeshow test was used to assess the model fit. Results: A total of 94 cases presented with PPH in this study, and the incidence of PPH was 5.10% (94/1840). Two items including macrosomia (odds ratio (OR): 2.229, 95% confidence interval (95% CI): 1.062–4.679) and placental anomalies (OR: 4.095, 95% CI: 2.488–6.742) were independent risk factors affecting the occurrence of PPH with vaginal delivery (p < 0.05). Conclusion: The construction of a logistic regression-based model can be used to predict the risk of PPH after vaginal delivery, predictability to be studied further. Clinically, more attention should be paid to vaginal delivery, early identification and screening of high-risk factors for PPH, as well as timely preventive interventions for high-risk groups so as to reduce the risk of PPH.https://www.imrpress.com/journal/CEOG/51/10/10.31083/j.ceog5110221postpartum hemorrhagemultivariate logistic regressionprediction modelpregnancy
spellingShingle Yongjuan Bi
Yanhua Zhang
Li Li
Jing Bai
Jing Li
Risk Factors and Predictive Models for Postpartum Hemorrhage after Vaginal Delivery
Clinical and Experimental Obstetrics & Gynecology
postpartum hemorrhage
multivariate logistic regression
prediction model
pregnancy
title Risk Factors and Predictive Models for Postpartum Hemorrhage after Vaginal Delivery
title_full Risk Factors and Predictive Models for Postpartum Hemorrhage after Vaginal Delivery
title_fullStr Risk Factors and Predictive Models for Postpartum Hemorrhage after Vaginal Delivery
title_full_unstemmed Risk Factors and Predictive Models for Postpartum Hemorrhage after Vaginal Delivery
title_short Risk Factors and Predictive Models for Postpartum Hemorrhage after Vaginal Delivery
title_sort risk factors and predictive models for postpartum hemorrhage after vaginal delivery
topic postpartum hemorrhage
multivariate logistic regression
prediction model
pregnancy
url https://www.imrpress.com/journal/CEOG/51/10/10.31083/j.ceog5110221
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