Background
Methods
Results
Variable | Postpartum haemorrhage (N = 59,639) | No postpartum haemorrhage (N = 759,326) |
---|---|---|
Maternal age (years) | ||
Under 20 | 2386 (4.0) | 27407 (3.6) |
20–34 | 45012 (75.5) | 562067 (74.0) |
35+ | 12241 (20.5) | 169852 (22.4) |
Smoker | 6524 (10.9) | 88992 (11.7) |
Australian born | 38530 (64.6) | 523266 (68.9) |
Multiple birth | 1647 (2.8) | 10927 (1.4) |
Parity | ||
1st | 29179 (48.9) | 317620 (41.8) |
2nd-4th | 28021 (47.0) | 412846 (54.4) |
5+ | 2366 (4.0) | 27588 (3.6) |
Previous Caesarean | 5489 (9.2) | 111610 (14.7) |
Gestational diabetes | 3842 (6.4) | 45688 (6.0) |
Pregnancy hypertension | 6740 (11.3) | 69387 (9.1) |
Antepartum haemorrhage | 2440 (4.1) | 19246 (2.5) |
Malpresentation | 2037 (3.4) | 35981 (4.7) |
Previous PPH | 10823 (18.1) | 27116 (3.6) |
Placenta praevia | 1253 (2.1) | 7678 (1.0) |
Morbidly adherent placenta | 1163 (2.0) | 826 (0.1) |
Gestational age (weeks) | ||
20–32 | 1372 (2.3) | 11654 (1.5) |
33–36 | 3023 (5.1) | 37969 (5.0) |
37+ | 55244 (92.6) | 709703 (93.5) |
Mode of birth | ||
Normal vaginal delivery | 36717 (61.6) | 451652 (59.5) |
Caesarean | 11860 (19.9) | 228010 (30.0) |
Caesarean without labour | 5465 (9.2) | 133292 (17.6) |
Caesarean with labour | 6393 (10.7) | 94704 (12.5) |
Instrumental delivery | 11186 (18.8) | 80382 (10.6) |
Forceps | 4802 (8.1) | 26272 (3.5) |
Vacuum | 6384 (10.7) | 54110 (7.1) |
Induction of labour | 20479 (34.3) | 202866 (26.7) |
Large for gestational age | 9197 (15.4) | 78804 (10.4) |
Hospital type | ||
Tertiary | 31503 (52.8) | 307664 (40.5) |
Regional | 11561 (19.4) | 161522 (21.3) |
Urban/other | 8754 (14.7) | 99859 (13.2) |
Private | 7821 (13.1) | 190281 (25.1) |
Subsequent morbidity among women with a postpartum haemorrhage
Vaginal births N = 46955 | Caesarean births N = 11037 | |||
---|---|---|---|---|
Unadjusted OR | Adjusted ORb | Unadjusted OR | Adjusted ORb | |
Year of birth
| ||||
2003 |
Ref
|
Ref
| Ref | Ref |
2004 |
0.87 (0.65, 1.17)
|
0.90 (0.66, 1.21)
| 1.20 (0.80, 1.79) | 1.13 (0.74, 1.72) |
2005 |
0.76 (0.56, 1.03)
|
0.79 (0.58, 1.08)
| 1.16 (0.78, 1.71) | 1.14 (0.76, 1.73) |
2006 |
0.70 (0.52, 0.94)
|
0.70 (0.52, 0.96)
| 1.13 (0.77, 1.65) | 1.03 (0.69, 1.55) |
2007 |
0.70 (0.52, 0.94)
|
0.69 (0.51, 0.94)
| 1.30 (0.89, 1.90) | 1.10 (0.73, 1.65) |
2008 |
0.93 (0.70, 1.22)
|
0.90 (0.78, 1.20)
| 1.18 (0.81, 1.73) | 1.04 (0.69, 1.55) |
2009 |
0.91 (0.69, 1.20)
|
0.91 (0.69, 1.21)
| 1.00 (0.69, 1.46) | 0.87 (0.58, 1.30) |
2010 |
0.65 (0.48, 0.88)
|
0.64 (0.47, 0.87)
| 0.78 (0.53, 1.16) | 0.67 (0.44, 1.01) |
2011 |
0.86 (0.65, 1.13)
|
0.86 (0.65, 1.14)
| 1.02 (0.70, 1.48) | 0.87 (0.58, 1.29) |
Maternal Age
| ||||
Under 20 |
1.02 (0.71, 1.46)
|
0.39 (0.14, 1.08)
| ||
20–34 |
Ref
|
Ref
| ||
35+ |
1.31 (1.10, 1.55)
|
1.16 (0.97, 1.40)
| ||
Private patient
| 0.89 (0.69, 1.14) | 0.92 (0.69, 1.21) | ||
Smoker
| 1.02 (0.82, 1.27) | 1.12 (0.86, 1.45) | ||
Parity
| ||||
1 | ||||
2–4 | 0.87 (0.74, 1.03) |
1.29 (1.04, 1.64)
| ||
5+ | 0.80 (0.55, 1.17) |
1.53 (1.04, 2.24)
| ||
Australian born
|
0.82 (0.70, 0.96)
|
0.72 (0.60, 0.87)
| ||
Gestational Age
| ||||
20–32 weeks |
2.43 (1.62, 3.65)
|
2.27 (1.61, 3.22)
| ||
33–36 weeks |
1.28 (0.92, 1.79)
|
1.52 (1.16, 1.98)
| ||
37+ weeks |
Ref
|
Ref
| ||
Mode of birth
| ||||
Vaginal | Ref | |||
Forceps | 1.19 (0.95, 1.50) | . | ||
Vacuum | 1.14 (0.92, 1.41) | . | ||
Caesarean in labour |
1.64 (1.32, 2.03)
| |||
Pre-labour caesarean | ||||
Induction
| 1.10 (0.95, 1.27) |
1.31 (1.03, 1.67)
| ||
Large for gestational age
| 0.84 (0.68, 1.04) | 0.82 (0.65, 1.03) | ||
Chronic conditions
|
2.94 (2.08, 4.14)
|
2.07 (1.45, 2.97)
| ||
Pregnancy factors
| ||||
Antepartum haemorrhage |
1.42 (1.02, 1.96)
| 1.04 (0.78, 1.39) | ||
Previous caesarean |
1.77 (1.33, 2.35)
|
1.80 (1.43, 2.26)
| ||
Previous PPH |
1.48 (1.25, 1.75)
|
1.75 (1.44, 2.12)
| ||
Malpresentation | 1.39 (0.59, 3.28) | 1.01 (0.78, 1.29) | ||
Morbidly adherent placenta |
4.25 (3.20, 5.64)
|
10.21 (7.78, 13.40)
| ||
Placenta praevia |
2.31 (1.80, 2.96)
| |||
Gestational diabetes | 1.12 (0.85, 1.46) | 0.94 (0.70, 1.27) | ||
Pregnancy hypertension |
1.52 (1.24, 1.85)
|
1.58 (1.25, 1.98)
| ||
Hospital
| ||||
Tertiary | Ref | Ref | ||
Urban | 1.15 (0.95, 1.41) | 1.00 (0.76, 1.32) | ||
Regional | 1.16 (0.96, 1.41) | 1.23 (0.95, 1.58) | ||
Private | 1.05 (0.77, 1.43) | 1.29 (0.90, 1.85) |
Transfusion among women with a postpartum haemorrhage
Vaginal births N = 46955 | Caesarean births N = 11037 | |||
---|---|---|---|---|
Unadjusted OR | Adjusted ORa | Unadjusted OR | Adjusted ORa | |
Year of birth
| ||||
2003 |
Ref
|
Ref
| Ref | Ref |
2004 |
1.03 (0.90, 1.18)
|
1.03 (0.90, 1.18)
| 0.91 (0.70, 1.17) | 0.90 (0.67, 1.17) |
2005 |
1.07 (0.94. 1.22)
|
1.08 (0.95, 1.24)
| 0.91 (0.70, 1.16) | 0.92 (0.71, 1.18) |
2006 |
1.13 (0.99, 1.28)
|
1.13 (0.99, 1.29)
| 0.92 (0.72, 1.16) | 0.88 (0.68, 1.13) |
2007 |
1.18 (1.04, 1.34)
|
1.15 (1.01, 1.31)
| 1.19 (0.94, 1.50) | 1.11 (0.87, 1.42) |
2008 |
1.08 (0.95, 1.22)
|
1.05 (0.92, 1.19)
| 1.01 (0.80, 1.26) | 0.96 (0.75, 1.23) |
2009 |
1.18 (1.04, 1.34)
|
1.15 (1.01, 1.31)
| 1.01 (0.80, 1.26) | 0.97 (0.77, 1.24) |
2010 |
1.20 (1.06, 1.36)
|
1.16 (1.02, 1.31)
| 0.96 (0.77, 1.21) | 0.91 (0.72, 1.16) |
2011 |
1.29 (1.15, 1.46)
|
1.23 (1.08, 1.39)
| 0.89 (0.71, 1.11) | 0.84 (0.66, 1.06) |
Maternal Age
| ||||
Under 20 |
1.29 (1.14, 1.46)
|
1.99 (1.47, 2.69)
| ||
20–34 |
Ref
|
Ref
| ||
35+ |
1.11 (1.03, 1.20)
|
1.11 (0.99, 1.25)
| ||
Private patient
|
0.87 (0.78, 0.96)
| 0.93 (0.78, 1.10) | ||
Smoker
|
1.16 (1.07, 1.27)
| 0.98 (0.83, 1.16) | ||
Parity
| ||||
1 | ||||
2–4 |
0.79 (0.74, 0.85)
|
1.25 (1.09, 1.44)
| ||
5+ |
0.84 (0.72, 0.99)
|
2.13 (1.68, 2.71)
| ||
Australian born
| 0.95 (0.89, 1.01) |
0.74 (0.66, 0.83)
| ||
Gestational Age
| ||||
20–32 weeks |
1.21 (0.95, 1.54)
|
1.79 (1.40, 2.30)
| ||
33–36 weeks |
1.38 (1.20, 1.59)
|
1.07 (0.88, 1.29)
| ||
37+ weeks | ||||
Mode of birth
| ||||
Vaginal | ||||
Forceps | 1.70 (1.55, 1.86) | |||
Vacuum | 1.32 (1.21, 1.43) | |||
Caesarean in labour |
1.57 (1.37, 1.79)
| |||
Pre-labour caesarean | ||||
Induction
|
1.12 (1.06, 1.19)
| 1.01 (0.87, 1.16) | ||
Large for gestational age
|
1.09 (1.01, 1.18)
| 1.13 (0.99, 1.28) | ||
Chronic conditions
|
1.27 (1.03, 1.57)
| 1.23 (0.94, 1.62) | ||
Pregnancy factors
| ||||
Antepartum haemorrhage |
1.49 (1.30, 1.72)
|
1.47 (1.23, 1.76)
| ||
Previous caesarean |
1.43 (1.25, 1.63)
| 1.03 (0.89, 1.19) | ||
Previous PPH |
1.40 (1.31, 1.51)
|
1.27 (1.12, 1.44)
| ||
Malpresentation | 1.07 (0.68, 1.69) | 1.03 (0.87, 1.20) | ||
Morbidly adherent placenta |
3.88 (3.32, 4.53)
|
5.21 (4.06, 6.68)
| ||
Placenta praevia | 3.09 (2.62, 3.65) | |||
Gestational diabetes | 1.00 (0.89, 1.13) | 0.92 (0.76, 1.10) | ||
Pregnancy hypertension |
1.38 (1.26, 1.50)
| 1.12 (0.97, 1.31) | ||
Hospital
| ||||
Tertiary |
Ref
|
Ref
| ||
Urban |
1.05 (0.97, 1.14)
|
1.03 (0.87, 1.21)
| ||
Regional |
1.29 (1.20, 1.39)
|
1.54 (1.33, 1.79)
| ||
Private |
0.88 (0.77, 1.00)
|
1.64 (1.31, 2.05)
|