Risk Factors for Postpartum Hemorrhage Following Vaginal Deliveries in China: A Case-Control Study of Second Births After IUD Removal
Year: 2025
Type: article
Abstract: Liping Shen, Yang Xu, Baoxia Li, Yuyun Long Department of Family Planning, Maternal and Child Health Hospital of Lianyungang City, Lianyungang, Jiangsu Province, 222000, People’s Republic of ChinaCorrespondence: Yuyun Long, Department of Family Planning, Maternal and Child Health Hospital of Lianyungang City, No. 669 Qindongmen Street, Haizhou District, Lianyungang City, Jiangsu Province, 222000, People’s Republic of China, Email [email protected]: This study aims to evaluate the predictive value of risk factors for postpartum hemorrhage (PPH) following vaginal delivery, with a special focus on the impact of intrauterine device (IUD) usage in the context of recent policy changes allowing more childbirths in China.Methods: A total of 6879 women who underwent vaginal deliveries from January 2021 to December 2023 in the Lianyungang regional maternal care system and met the inclusion and exclusion criteria were enrolled. A case-control design was employed, comprising 524 women with PPH (blood loss ≥ 500 mL) 24h after giving birth and an equal number of controls (blood loss < 500 mL) matched on a 1:1 ratio. Univariate and multivariate logistic regression analyses, alongside ROC curve analysis, were conducted to identify risk factors for PPH.Results: Univariate analysis revealed significant differences in age (OR = 1.86, 95% CI: 1.35– 2.57, P < 0.01), number of miscarriages (OR = 1.97, 95% CI: 1.46– 2.65, P < 0.001), gestational week, number of fetuses, weight of the second child (OR = 10.78, 95% CI: 7.88– 14.75, P < 0.001), placental adhesion, and uterine atony (OR = 2.40, 95% CI: 1.60– 3.61, P < 0.001). No significant differences were observed regarding occupation, educational level, mode of first delivery, IUD use and duration, and presence of gestational diabetes or hypertension (P > 0.05). Multivariate logistic regression identified age, number of miscarriages, weight of the second child, and uterine atony as independent risk factors for PPH (P < 0.05). ROC curve analysis showed that the combined predictive value of these factors was superior, with an AUC of 0.805 for the combined predictive model.Conclusion: PPH is influenced by advanced maternal age, multiple miscarriages, high birth weight, and uterine atony. IUD use may not independently impact the likelihood of PPH under the conditions studied.Keywords: intrauterine device, postpartum hemorrhage, vaginal delivery, risk factors
Authors: Shen L, Xu Y, Li B, Long Y
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7052583364
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