How well do postpartum blood loss and common definitions of postpartum hemorrhage correlate with postpartum anemia and fall in hemoglobin?

• Published in: PloS one 2019-08, Vol.14 (8), p.e0221216-e0221216
• Main Authors: Anger, Holly, Durocher, Jill, Dabash, Rasha, Winikoff, Beverly
• Format: Article
• Language: English
• Subjects: Adult; Analysis of Variance; Anemia; Anemia - blood; Anemia - diagnosis; Biology and Life Sciences; Births; Blood; Blood & organ donations; Childbirth & labor; Correlation; Correlation coefficient; Correlation coefficients; Correlation of Data; Delivery (Childbirth); Delivery, Obstetric; Female; Glycosylated hemoglobin; Hemoglobin; Hemoglobins; Hemoglobins - metabolism; Hemorrhage; Humans; Markers; Maternal & child health; Measurement; Medicine and Health Sciences; Morbidity; Obstetrics; Patient outcomes; People and Places; Physiology; Postpartum; Postpartum Hemorrhage - blood; Postpartum Hemorrhage - diagnosis; Postpartum period; Pregnancy; Risk factors; Secondary analysis; Vagina; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0221216

We aimed to better understand how well postpartum blood loss and common postpartum hemorrhage (PPH) definitions (i.e. blood loss ≥500ml = PPH, ≥1000ml = "severe" PPH) correlate with postpartum anemia and fall in hemoglobin. Secondary analysis of data from three randomized trials that objectively measured postpartum blood loss and pre- and post-delivery hemoglobin among vaginal deliveries: one trial included 1056 home-births in Pakistan and two multi-country hospital-based trials included 1279 women diagnosed with PPH. We calculated Spearman's correlation coefficients (rs) for blood loss with hemoglobin drop and postpartum hemoglobin, and we compared PPH blood loss markers (≥500ml, ≥1000ml) with large hemoglobin drops (≥2 g/dL) and the threshold for moderate postpartum anemia (