Abstract:Objective To investigate the risk factors of postpartum hemorrhage and construct prediction model of postpartum hemorrhage among low-risk primiparas.Methods A total of 600 low risk primiparas who were aged 18-34 years, underwent regular obstetric examination, had no gestational complications, and delivered vaginally were identified from a tertiary hospital in Beijing from May 2017 to July 2019, including 300 women with postpartum hemorrhage ≥500 mL(case group) and 300 matched controls with postpartum bleeding <300 mL. All data were retrieved from electronic medical records. Multivariable logistic regression was used to explore potential risk factors of postpartum hemorrhage and develop a prediction model of postpartum hemorrhage.Results In the univariate analysis, maternal age, gestational week, duration of the second stage of labor, duration of the third stage of labor, prepartum hemoglobin, perineal incision, and neonatal weight were all significantly different(P<0.05) between the two groups. Multivariable logistic regression showed that five factors including age(year), duration of the second stage of labor(/10 minutes), duration of the third stage of labor(minute), lateral perineal resection, and newborn weight(/100 g) were the independent risk factors of postpartum hemorrhage; the corresponding ORs were 1.10(95% CI:1.02-1.18), 1.05(95% CI:1.01-1.09), 1.07(95% CI:1.03-1.12), 1.44(95% CI:1.01-2.05), and 1.12(95% CI:1.06-1.19), respectively. The pre-partum hemoglobin(/10 g/L) was the protective factor of postpartum hemorrhage, and the corresponding OR was 0.65(95% CI:0.56-0.76). The c-index of the prediction model was 0.71(95% CI:0.67-0.75), and a nomogram predicting postpartum hemorrhage in low-risk primiparas was established.Conclusion For low-risk primiparas, maternal age, duration of the second stage of labor, duration of the third stage of labor, perineal lateral incision, and birth weight are independent risk factors of postpartum hemorrhage, while prepartum hemoglobin is a protective factor of postpartum hemorrhage.
倪胜莲, 曹琳琳, 郭志超, 卢丰刀女, 陶立元, 赵扬玉. 低风险初产妇产后出血风险预测[J]. 中国生育健康杂志, 2021, 32(2): 117-121.
NI Shenglian, CAO Linlin, GUO Zhichao, LU Jie, TAO Liyuan, ZHAO Yangyu. Prediction of postpartum hemorrhage among low-risk primiparas. Chinese Journal of Reproductive Health, 2021, 32(2): 117-121.