Cheng CeCe, Munter Bryce T, Lee Michaela Y, Sundjaja Claire D, Paul Natasha D, Klausmeyer Margaret M, Yammine Nastassia A, Ramsey Patrick S, Byrne John J
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
J Clin Med. 2025 Sep 5;14(17):6283. doi: 10.3390/jcm14176283.
Our primary objective was to determine whether patients with a higher body mass index (BMI) who experienced postpartum hemorrhage (PPH) required ≥2 uterotonics more often than those with lower BMI. We conducted a retrospective cohort study that included all patients who experienced a PPH between 1 August 2020 and 31 July 2022. Extracted data included patient demographics, PPH risk factors, details regarding the labor course and hemorrhage management, and maternal and neonatal outcomes, such as mode of delivery, etiology of hemorrhage, need for nonpharmacological management, neonatal Apgar scores, requirement for phototherapy, neonatal intensive care unit (NICU) admission, and NICU length of stay. All variables were compared between four BMI classes: non-obese and classes I, II, and III obesity. Possible confounding factors were assessed with a logistic regression analysis. Of the 6732 deliveries that occurred during the study period, a total of 891 (13.2%) patients had PPH. Differences were noted in the number of uterotonics used, although no direct correlation was found between increasing BMI class and the use of ≥2 uterotonics. Patients with higher BMIs were more likely to require cesarean delivery, have a classical hysterotomy incision, and have a hysterotomy extension, and were less likely to need a blood transfusion ( < 0.05 for all). There was no difference in the rate of uterine atony or other etiologies of hemorrhage, and no difference was observed in the non-pharmacologic management of hemorrhage between groups. In our study population, BMI alone does not appear to be directly associated with the use of ≥2 uterotonics.
我们的主要目的是确定体重指数（BMI）较高的产后出血（PPH）患者是否比BMI较低的患者更频繁地需要≥2种宫缩剂。我们进行了一项回顾性队列研究，纳入了2020年8月1日至2022年7月31日期间所有发生PPH的患者。提取的数据包括患者人口统计学信息、PPH危险因素、分娩过程和出血管理的详细情况，以及母婴结局，如分娩方式、出血病因、非药物治疗的需求、新生儿阿氏评分、光疗需求、新生儿重症监护病房（NICU）入院情况和NICU住院时间。在四个BMI类别之间比较了所有变量：非肥胖以及I、II和III级肥胖。通过逻辑回归分析评估可能的混杂因素。在研究期间发生的6732例分娩中，共有891例（13.2%）患者发生PPH。尽管未发现BMI类别增加与使用≥2种宫缩剂之间存在直接相关性，但在使用宫缩剂的数量上存在差异。BMI较高的患者更有可能需要剖宫产、采用经典子宫下段剖宫产切口并出现子宫下段剖宫产切口延长，且不太可能需要输血（所有情况均P<0.05）。子宫收缩乏力或其他出血病因的发生率没有差异，各组之间在出血的非药物治疗方面也没有差异。在我们的研究人群中，仅BMI似乎与使用≥2种宫缩剂没有直接关联。
