Increased postpartum hemorrhage rates in Australia

Abstract Objective To determine whether changes in risk factors for postpartum hemorrhage (PPH) over time are associated with a rise in postpartum hemorrhage rates. Methods Population-based study using linked hospital discharge and birth records from New South Wales, Australia for 752,374 women givi...

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Bibliographic Details
Published in:International journal of gynecology and obstetrics 2007-09, Vol.98 (3), p.237-243
Main Authors: Ford, J.B, Roberts, C.L, Simpson, J.M, Vaughan, J, Cameron, C.A
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Birth Weight
Cesarean Section - statistics & numerical data
Childbirth
Data linkage
Epidemiology
Female
Humans
Infant, Newborn
Morbidity
New South Wales - epidemiology
Obstetrics and Gynecology
Parity
Postpartum hemorrhage
Postpartum Hemorrhage - epidemiology
Pregnancy
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Summary:Abstract Objective To determine whether changes in risk factors for postpartum hemorrhage (PPH) over time are associated with a rise in postpartum hemorrhage rates. Methods Population-based study using linked hospital discharge and birth records from New South Wales, Australia for 752,374 women giving birth, 1994–2002. Analyses include a description of trends and regression analysis of risk factors for postpartum hemorrhage and comparison of predicted and observed rates of postpartum hemorrhage over time. Results Increasing proportions of women aged 35 years or older, born overseas, nulliparous, having cesarean births, having inductions and/or epidurals, postterm deliveries and large babies were evident. Observed postpartum hemorrhage rates increased from 4.7 to 6.0 per 100 births ( P < 0.001) while expected rates, adjusted for covariates, remained steady ( P = 0.28). Conclusion Increases in postpartum hemorrhage are not explained by the changing risk profile of women. It may be that changes in management and/or reporting of postpartum hemorrhage have resulted in higher postpartum hemorrhage rates.
ISSN:0020-7292
1879-3479
DOI:10.1016/j.ijgo.2007.03.011