Evidence map›Paper›PMID 27618767›Full record

Trial reportTransfusion2017

Patterns and predictors of severe postpartum anemia after Cesarean section.

Alexander J Butwick, Eileen M Walsh, Michael Kuzniewicz, Sherian X Li, Gabriel J Escobar

Open access · greenAbstract readClinical TrialMulticenter Study
In one paragraph

Trial report in Transfusion, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 4 pooled it
9.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 4 syntheses or guidelines pooled it, 74 citations in OpenAlex.

  1. Pooled it
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  3. Prenatal anemia and postpartum hemorrhage risk: A systematic review and meta-analysis.The journal of obstetrics and gynaecology research · 2021
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  10. Postpartum anemia and maternal wellbeing: A cohort analysis of the WOMAN-2 trial.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Alexander J ButwickDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.
Eileen M WalshDivision of Research, Kaiser Permanente Northern California, Oakland, California.
Michael KuzniewiczDivision of Research, Kaiser Permanente Northern California, Oakland, California.
Sherian X LiDivision of Research, Kaiser Permanente Northern California, Oakland, California.
Gabriel J EscobarDivision of Research, Kaiser Permanente Northern California, Oakland, California.
Kaiser Permanente · USStanford University · US

Funding

Postpartum Hemmorrhage and Anemia: Epidemiologic and Cost-Effectiveness AnalysesK23HD070972 · NICHD · STANFORD UNIVERSITY · PI BUTWICK, ALEXANDER JAMES · 2013 to 2017
$699k
NICHD NIH HHS K23 HD070972
6 · The paper itself

Abstract

backgroundPostpartum anemia is associated with maternal and perinatal morbidity. Population-level data may inform guideline development for postpartum anemia screening. Our objectives were to evaluate the associations between potential predictors (predelivery anemia and postpartum hemorrhage [PPH]) with severe postpartum anemia after Cesarean section. STUDY DESIGN AND

methodsData were collected from 70,939 hospitalizations for Cesarean section performed at Kaiser Permanente Northern California facilities between 2005 and 2013. Severe postpartum anemia was defined as a hemoglobin (Hb) level of less than 8 g/dL before hospital discharge. Using multivariable logistic regression, we assessed the associations between predelivery anemia and PPH with severe postpartum anemia. Distributions of these characteristics among women with severe postpartum anemia were evaluated.

resultsThe overall rate of severe postpartum anemia was 7.3% (95% confidence interval [CI], 7.1%-7.4%). Severe postpartum anemia was strongly associated with a predelivery Hb level between 10 and 10.9 g/dL (adjusted odds ratio [aOR], 5.4; 95% CI, 4.89-5.91), predelivery Hb level of less than 10 g/dL (aOR, 30.6; 95% CI, 27.21-34.6), and PPH (aOR, 8.45; 95% CI, 7.8-9.16). The proportions of women with severe postpartum anemia were highest for those experiencing PPH but no predelivery anemia (12.2%; 95% CI, 11.0%-13.6%) and those who did not incur PPH nor predelivery anemia (10.7%; 95% CI, 9.6%-12.0%).

conclusionsOur findings suggest that PPH and predelivery anemia are strong independent risk factors for severe postpartum anemia. Optimization of patients' Hb before delivery may reduce the incidence of severe anemia after Cesarean section.

Indexed as

Cesarean SectionAdultAnemiaCaliforniaFemaleHemoglobinsHumansInfant, NewbornMalePostpartum HemorrhagePregnancyPregnancy Complications, HematologicRisk FactorsHemoglobins

Identifiers

PMID27618767
PMCPMC5243180
OpenAlexW2523917024

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.