Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Geisinger Medical Center, Danville, PA, USA.
Gynecol Obstet Invest. 2012;73(1):70-4. doi: 10.1159/000329335. Epub 2011 Sep 15.
BACKGROUND/AIMS: The purpose of this study was to determine the relationship between maternal characteristics and severe postpartum hemorrhage (PPH).
Medical records of women who delivered at Duke University Hospital between 2001 and 2004 with an ICD-9 code for PPH were reviewed. Women with PPH who received blood component therapy (severe PPH) were selected as cases and compared with controls matched for age, parity and mode of delivery.
Among 12,476 deliveries, there were 109 women with severe PPH. Hispanic women had an almost fourfold increase in the odds of severe PPH [OR 3.9 (1.8, 8.7)] that persisted when controlling for other significant predictors of PPH. Women with PPH were almost two times more likely [OR 1.8 (1.1, 3.1)] to have a BMI <30 when controlling for Hispanic ethnicity, oxytocin exposure, labor induction, treatment with magnesium and chorioamnionitis.
Systemic factors as well as obstetrical factors modify the risk of severe PPH. Hispanic women and women with a BMI <30 are more likely to have severe PPH. When mode of delivery is controlled for, BMI ≥30 is associated with a reduced risk of severe PPH.
背景/目的：本研究旨在确定产妇特征与严重产后出血（PPH）之间的关系。
回顾了 2001 年至 2004 年在杜克大学医院分娩且 ICD-9 编码为 PPH 的妇女的病历。选择接受血液成分治疗（严重 PPH）的 PPH 妇女作为病例，并与年龄、产次和分娩方式相匹配的对照组进行比较。
在 12476 次分娩中，有 109 名妇女出现严重 PPH。西班牙裔妇女发生严重 PPH 的几率几乎增加了四倍[比值比 3.9（1.8，8.7）]，在控制了其他 PPH 重要预测因素后仍如此。在控制了西班牙裔、催产素暴露、引产、硫酸镁治疗和绒毛膜羊膜炎等因素后，患有 PPH 的妇女发生 BMI<30 的几率几乎增加了两倍[比值比 1.8（1.1，3.1）]。
系统性因素和产科因素都会改变严重 PPH 的风险。西班牙裔妇女和 BMI<30 的妇女更有可能发生严重 PPH。当控制分娩方式时，BMI≥30 与严重 PPH 的风险降低相关。
