A Case Control Study On The Determinants Of Postpartum Hemorrhage Among Pregnant Women In Hospitalization

OBJECTIVES:To analyze the determinants of postpartum hemorrhage among pregnant women in hospitalization, and to provide the basic information for clinic research and preventive intervention for postpartum hemorrhage.Methods:Between December2008and December2011, a case control study was conducted in a maternal and child hospital. The pregnant women with postpartum hemorrhage selected as a case group, and the women without postpartum hemorrhage as a control group sampling from the women during the same period in hospitalization. Univariate analysis and multivariate such as logistic regression analysis were performed to explore and analyze the determinants of postpartum hemorrhage, such determinants involved age, BMI, abortion history, pluripara, liver and renal function, severe anemia, prenatal examination times, blood system diseases, gestational weeks, delivery ways, birth weight, polyembryony, analgesic usage, uterine atony, early suckling or not.Results:From December2008to December2011, A total of69cases postpartum hemorrhage were found among9074cases pregnant women delivered in hospitalization, and the occurrence rate of PPH was0.76%in this hospital. Univariate analysis showed that older pregnancy (OR=2.6,P=0.019), liver and renal function(OR=3.5,P=0.001), severe anemia(OR=27.3, P=0.000), prenatal examination times (OR=0.3,P=0.029) uterine atony (OR=5.2, P=0.017) were significantly associated with the incidence rate of PPH, the measuring index such as HCT(hematokrit)、 platelet、TBA(total bile acid)、urobilinogen had also statistical correlation with PPH(P<0.05).The others factors were found no significant effect on PPH(P>0.05).The multivariate logistic regression analysis showed that severe anemia (OR=30.8,P=0.003), uterine atony (OR=6.1,P=0.017), older pregnancy (OR=4.7, P=0.004) and kidney and liver function abnormal (OR=4.1, P=0.005) were the independent determinants of postpartum hemorrhage.Conclusion:The study findings imply that the occurrence rate of postpartum hemorrhage in this hospital is lower than that of the reported literatures. Severe anemia, uterine atony, older pregnancy, abnormal kidney and liver function are the independent determinants of postpartum hemorrhage. The commendations including rational nutrition, fostering prenatal care, avoiding older pregnancy, preventing implications among pregnant women are made to reduce the occurrence of postpartum hemorrhage.