Evidence map›Paper›PMID 28068990›Full record

ArticleBMC pregnancy and childbirth2017

Risk factors for severe postpartum hemorrhage: a case-control study.

Lill Trine Nyfløt, Irene Sandven, Babill Stray-Pedersen, Silje Pettersen, Iqbal Al-Zirqi, Margit Rosenberg, Anne Flem Jacobsen, Siri Vangen

2 registry-linked trialsOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pregnancy and childbirth, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 105 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
105citing papers in PubMed, 10 pooled it
34.5field-weighted citation impact, top 1% 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.

NCT05479357 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Carbetocin Versus Oxytocin for Prophylaxis Against Atonic Primary Post-partum Hemorrhage in High-risk Patients in Sohag University Hospital: A Randomized Controlled Clinical Trial

TypeinterventionalSponsorSohag UniversityRan2022 to 2022Enrolled80ConditionsAtonic Postpartum Hemorrhage, High Risk PregnancyArmsOxytocin, Carbetocin
NCT05525143 completednot on this mapstarted 2022, after this paper: background citation

Incidence and Risk Factors of Postpartum Hemorrhage at the Brugmann University Hospital in Comparison to the Literature

TypeobservationalSponsorBrugmann University HospitalRan2022 to 2023Enrolled2,402ConditionsPostpartum HemorrhageArmsPregnant women who have given birth vaginally or by cesarean section
3 · Its place in the literature

Who cites it

105 citing papers in PubMed, 10 syntheses or guidelines pooled it, 313 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Prenatal anemia and postpartum hemorrhage risk: A systematic review and meta-analysis.The journal of obstetrics and gynaecology research · 2021
    Pooled it
  8. Pooled it
  9. Pooled it
  10. Prepartum Anemia and Risk of Postpartum Hemorrhage: A Meta-Analysis and Brief Review.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Pooled it
  11. Intrapartum oral azithromycin for maternal infection prophylaxis and the risk of postpartum hemorrhage: A secondary analysis of the A-PLUS trial.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
    Trial
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article

45 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Lill Trine NyfløtDivision of Gynecology and Obstetrics, Oslo University Hospital, Rikshospitalet, P.O.box 4950, Nydalen, 0424, Oslo, Norway. l.t.nyflot@medisin.uio.no.
Irene SandvenOslo Centre of Biostatistics and Epidemiology, Research Support Services, Sogn Arena, P.O.box 4950, Nydalen, 0424, Oslo, Norway.
Babill Stray-PedersenInstitute of Clinical Medicine, Faculty of Medicine, University of Oslo, P.O. box 1171, Blindern, 0318, Oslo, Norway.
Silje PettersenDivision of Gynecology and Obstetrics, Oslo University Hospital, Rikshospitalet, P.O.box 4950, Nydalen, 0424, Oslo, Norway.
Iqbal Al-ZirqiDivision of Gynecology and Obstetrics, Oslo University Hospital, Rikshospitalet, P.O.box 4950, Nydalen, 0424, Oslo, Norway.
Margit RosenbergDepartment of Gynecology and Obstetrics, Drammen Hospital, P.O.box 800, 3004, Drammen, Norway.
Anne Flem JacobsenDivision of Gynecology and Obstetrics, Oslo University Hospital, Rikshospitalet, P.O.box 4950, Nydalen, 0424, Oslo, Norway.
Siri VangenInstitute of Clinical Medicine, Faculty of Medicine, University of Oslo, P.O. box 1171, Blindern, 0318, Oslo, Norway.
Oslo University Hospital · NOUniversity of Oslo · NODrammen Hospital · NOStatistics Norway · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn high-income countries, the incidence of severe postpartum hemorrhage (PPH) has increased. This has important public health relevance because severe PPH is a leading cause of major maternal morbidity. However, few studies have identified risk factors for severe PPH within a contemporary obstetric cohort.

methodsWe performed a case-control study to identify risk factors for severe PPH among a cohort of women who delivered at one of three hospitals in Norway between 2008 and 2011. A case (severe PPH) was classified by an estimated blood loss ≥1500 mL or the need for blood transfusion for excessive postpartum bleeding. Using logistic regression, we applied a pragmatic strategy to identify independent risk factors for severe PPH.

resultsAmong a total of 43,105 deliveries occurring between 2008 and 2011, we identified 1064 cases and 2059 random controls. The frequency of severe PPH was 2.5% (95% confidence interval (CI): 2.32-2.62). The most common etiologies for severe PPH were uterine atony (60%) and placental complications (36%). The strongest risk factors were a history of severe PPH (adjusted OR (aOR) = 8.97, 95% CI: 5.25-15.33), anticoagulant medication (aOR = 4.79, 95% CI: 2.72-8.41), anemia at booking (aOR = 4.27, 95% CI: 2.79-6.54), severe pre-eclampsia or HELLP syndrome (aOR = 3.03, 95% CI: 1.74-5.27), uterine fibromas (aOR = 2.71, 95% CI: 1.69-4.35), multiple pregnancy (aOR = 2.11, 95% CI: 1.39-3.22) and assisted reproductive technologies (aOR = 1.88, 95% CI: 1.33-2.65).

conclusionsBased on our findings, women with a history of severe PPH are at highest risk of severe PPH. As well as other established clinical risk factors for PPH, a history of severe PPH should be included as a risk factor in the development and validation of prediction models for PPH.

Indexed as

AdultAnemiaAnticoagulantsBlood TransfusionCase-Control StudiesCohort StudiesDelivery, ObstetricFemaleHumansLeiomyomaLogistic ModelsNorwayPlacenta DiseasesPostpartum HemorrhagePre-EclampsiaPregnancyAnticoagulantsCase-control studyHigh-riskObstetric interventionsPostpartum hemorrhagePredictionPredictorsPreventionRisk factors

Identifiers

PMID28068990
PMCPMC5223545
OpenAlexW2570128349

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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.