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Table 3 Temporal Trends in atonic postpartum hemorrhage by maternal, fetal and obstetrical characteristics, British Columbia, 2000-2009

From: Trends in postpartum hemorrhage from 2000 to 2009: a population-based study

  All years Rate per 100 deliveries 2009 vs. 2000 P for trend2
  n1 rate 2000 2001 2008 2009 RR 95% CI  
Parity          
 Nulliparous 12,237 6.5 5.5 5.5 8.1 7.6 1.39 1.29-1.51 <0.001
 Parous 9,863 4.4 4.2 4.2 5.3 5.2 1.24 1.14-1.35 <0.001
Maternal age (years)          
 <20 953 6.2 6.1 5.0 8.5 7.6 1.26 0.97-1.62 <0.001
 20-34 16,641 5.4 4.8 4.8 6.6 6.4 1.34 1.26-1.43 <0.001
 ≥35 4,506 5.2 4.4 4.7 6.3 5.9 1.34 1.18-1.53 <0.001
BMI          
 Underweight 1,032 6.0 4.8 5.2 7.4 6.8 1.43 1.09-1.87 <0.001
 Normal 9,960 5.7 5.1 5.1 6.9 6.8 1.33 1.22-1.47 <0.001
 Overweight 2,977 5.1 4.5 4.5 6.2 6.2 1.39 1.19-1.62 <0.001
 Obese 1,583 4.9 4.2 4.4 6.4 5.5 1.31 1.06-1.63 <0.001
Plurality          
 Singleton 21,529 5.3 4.7 4.7 6.5 6.3 1.33 1.25-1.41 <0.001
 Multiple 571 9.2 7.1 10.8 11.3 9.4 1.33 0.91-1.95 <0.001
Birthweight (grams)          
 <2500 794 3.7 3.2 4.0 5.0 3.7 1.17 0.85-1.61 0.03
 2500-3999 17,353 5.2 4.5 4.5 6.3 6.2 1.37 1.29-1.47 <0.001
 ≥4000 3,939 7.2 6.6 6.4 9.1 8.2 1.24 1.09-1.41 <0.001
Gestational age (weeks)          
 <28 68 2.0 2.14 0.69 3.13 1.5 0.71 0.25-2.01 0.53
 28-36 1,477 4.5 3.3 4.2 6.0 5.2 1.55 1.21-1.97 <0.001
 37-41 20,115 5.5 4.9 4.8 6.7 6.5 1.33 1.25-1.41 <0.001
 ≥42 396 6.2 5.8 5.3 6.9 5.9 1.03 0.68-1.57 0.52
Vaginal delivery          
 Spontaneous 14,400 5.8 5.1 5.2 7.1 6.8 1.33 1.24-1.42 <0.001
 Instrumental 5,141 11.5 8.9 10.3 14.6 14.2 1.59 1.42-1.79 <0.001
Cesarean delivery          
 No labour 912 1.7 1.6 1.3 2.1 2.1 1.28 0.94-1.73 <0.001
 With labour, no induction 1,001 2.4 1.6 1.5 3.5 3.0 1.92 1.43-2.58 <0.001
 With induction 646 2.9 1.9 1.5 3.9 3.5 1.74 1.20-2.54 <0.001
Previous cesarean          
 Yes 1,426 2.5 2.7 2.3 3.2 2.9 1.08 0.86-1.34 0.001
 No 20,674 5.8 5.1 5.1 7.2 6.9 1.37 1.30-1.46 <0.001
Induction of labour          
 Yes 5,648 6.4 5.4 5.4 8.4 7.7 1.41 1.26-1.58 <0.001
 No 16,452 5.1 4.6 4.6 6.1 6.0 1.31 1.22-1.40 <0.001
Augmentation of labour (oxytocin)          
 Yes 4,561 7.2 5.7 6.1 8.9 8.1 1.41 1.24-1.61 <0.001
 No 17,539 5.0 4.6 4.5 6.1 6.0 1.31 1.23-1.39 <0.001
Epidural analgesia          
 Yes 8,096 7.0 5.4 6.0 9.0 7.8 1.44 1.30-1.59 <0.001
 No 14,004 4.7 4.6 4.3 5.6 5.8 1.27 1.19-1.36 <0.001
  1. 1n refers to number of cases of atonic postpartum hemorrhage.
  2. 2P value based on data for all years between 2000 and 2009.
  3. RR denotes rate ratio and 95% CI denotes 95% confidence intervals.