Table 4 Temporal Trends in atonic postpartum hemorrhage with blood transfusion by maternal, fetal and obstetrical characteristics, British Columbia, 2000-2009
From: Trends in postpartum hemorrhage from 2000 to 2009: a population-based study
Parity | All years | Rate per 10,000 deliveries | 2009 vs. 2000 | P for trend2 | |||||
|---|---|---|---|---|---|---|---|---|---|
n1 | rate | 2000 | 2001 | 2008 | 2009 | RR | 95% CI | ||
Nulliparous | 534 | 15.3 | 20.1 | 19.9 | 39.5 | 31.3 | 1.56 | 1.04-2.34 | <0.001 |
Parous | 342 | 28.3 | 16.0 | 14.1 | 18.3 | 20.4 | 1.28 | 0.83-1.98 | 0.04 |
Maternal Age (in years) | |||||||||
<20 | 56 | 36.6 | 27.3 | 28.6 | 47.7 | 55.8 | 2.05 | 0.67-6.24 | 0.07 |
20-34 | 612 | 19.8 | 15.8 | 15.0 | 27.3 | 25.5 | 1.61 | 1.13-2.30 | <0.001 |
≥35 | 208 | 23.8 | 23.4 | 20.4 | 28.4 | 21.2 | 0.91 | 0.48-1.70 | 0.41 |
BMI | |||||||||
Underweight | 41 | 23.9 | 10.4 | 26.4 | 25.5 | 18.4 | 1.78 | 0.30-10.62 | 0.10 |
Normal | 362 | 20.6 | 16.3 | 19.1 | 30.4 | 20.4 | 1.25 | 0.77-2.03 | 0.03 |
Overweight | 115 | 19.8 | 17.3 | 13.6 | 25.0 | 24.1 | 1.39 | 0.62-3.08 | 0.02 |
Obese | 58 | 17.8 | 10.1 | 6.5 | 27.3 | 18.6 | 1.85 | 0.48-7.14 | 0.09 |
Plurality | |||||||||
Singleton | 832 | 20.5 | 17.0 | 15.3 | 27.0 | 24.8 | 1.46 | 1.07-1.97 | <0.001 |
Multiple | 44 | 70.7 | 76.3 | 113.9 | 105.6 | 68.0 | 0.89 | 0.24-3.30 | 0.84 |
Birthweight (in grams) | |||||||||
<2500 | 59 | 27.8 | 5.1 | 59.2 | 39.4 | 29.9 | 5.92 | 0.73-48.08 | 0.69 |
2500-3999 | 637 | 19.0 | 17.2 | 13.8 | 22.5 | 22.0 | 1.28 | 0.91-1.81 | 0.002 |
≥4000 | 177 | 32.3 | 26.0 | 18.8 | 58.3 | 45.4 | 1.75 | 0.92-3.32 | <0.001 |
Gestational age (in weeks) | |||||||||
<28 | 7 | 20.1 | 0.0 | 34.5 | 24.0 | 21.8 | - | - | 0.69 |
28-36 | 110 | 33.8 | 25.1 | 36.6 | 45.7 | 46.4 | 1.85 | 0.77-4.45 | 0.05 |
37-41 | 739 | 20.0 | 17.1 | 15.3 | 27.0 | 23.3 | 1.37 | 0.99-1.89 | <0.001 |
≥42 | 17 | 26.6 | 35.2 | 0.0 | 16.5 | 34.0 | 0.96 | 0.16-5.75 | 0.61 |
Vaginal delivery | |||||||||
Spontaneous | 321 | 12.9 | 11.8 | 10.2 | 17.6 | 16.4 | 1.39 | 0.87-2.21 | 0.004 |
Instrumental | 244 | 54.7 | 31.2 | 41.4 | 73.3 | 73.6 | 2.36 | 1.29-4.32 | <0.001 |
Cesarean delivery | |||||||||
No labour | 110 | 20.7 | 26.9 | 18.1 | 21.5 | 24.7 | 0.92 | 0.41-2.04 | 0.57 |
With labour, no induction | 129 | 30.4 | 31.2 | 30.0 | 33.7 | 29.0 | 0.93 | 0.43-2.01 | 0.59 |
With induction | 72 | 32.2 | 20.3 | 9.3 | 65.0 | 28.8 | 1.42 | 0.42-4.83 | 0.01 |
Previous cesarean | |||||||||
Yes | 111 | 19.8 | 29.5 | 18.4 | 27.6 | 29.1 | 0.99 | 0.50-1.97 | 0.60 |
No | 765 | 21.5 | 16.2 | 16.4 | 28.3 | 24.9 | 1.53 | 1.10-2.13 | <0.001 |
Induction of labour | |||||||||
Yes | 236 | 26.9 | 19.9 | 18.9 | 44.3 | 31.3 | 1.57 | 0.86-2.86 | 0.002 |
No | 640 | 19.7 | 17.3 | 16.0 | 24.1 | 24.0 | 1.39 | 0.99-1.96 | <0.001 |
Augmentation of labour (oxytocin) | |||||||||
Yes | 172 | 27.3 | 23.2 | 15.4 | 38.4 | 38.0 | 1.64 | 0.86-3.12 | <0.001 |
No | 704 | 20.2 | 16.9 | 16.9 | 26.2 | 23.1 | 1.37 | 0.98-1.92 | <0.001 |
Epidural analgesia | |||||||||
Yes | 340 | 29.4 | 23.4 | 20.9 | 40.2 | 35.4 | 1.51 | 0.92-2.48 | <0.001 |
No | 536 | 18.1 | 15.9 | 15.1 | 23.2 | 21.4 | 1.35 | 0.93-1.96 | 0.003 |