Observational studyAnesthesia and analgesia2017
Risk Factors for Severe Postpartum Hemorrhage After Cesarean Delivery: Case-Control Studies.
Observational study in Anesthesia and analgesia, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 4 of them syntheses that pooled it.
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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.
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.
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Who cites it
49 citing papers in PubMed, 4 syntheses or guidelines pooled it, 115 citations in OpenAlex.
- Pooled it
- Hemostatic biomarkers associated with postpartum hemorrhage: a systematic review and meta-analysis.Blood advances · 2023Pooled it
- Maternal low and high hemoglobin concentrations and associations with adverse maternal and infant health outcomes: an updated global systematic review and meta-analysis.BMC pregnancy and childbirth · 2023Pooled it
- Maternal hemoglobin concentrations across pregnancy and maternal and child health: a systematic review and meta-analysis.Annals of the New York Academy of Sciences · 2019Pooled it
- Accurate estimation of blood loss during cesarean deliveries: A secondary analysis of a randomized controlled trial comparing visual, quantitative and calculated approaches.Acta obstetricia et gynecologica Scandinavica · 2025Trial
- Development and validation of a clinical prediction model for postpartum hemorrhage after elective cesarean section.Journal of anesthesia · 2026Observational
- Maternal Intensive Care Unit Utilization by Mode of Delivery in the United States: A Retrospective Cohort Study.Anesthesia and analgesia · 2026Article
- Predictors of Postpartum Hemorrhage Following Repeat Cesarean Section: A Retrospective Cohort Study.Cureus · 2026Article
- The differential role of anesthetic technique by etiology of postpartum hemorrhage: a dual-cohort analysis of emergency cesarean delivery and placenta accreta spectrum.Frontiers in medicine · 2026Article
- The Rising Global Cesarean Section Rates and Their Impact on Maternal and Child Health: A Scoping Review.Journal of clinical medicine · 2025Review
- Incidence and Risk Factors of Postpartum Hemorrhage in Cesarean Versus Vaginal Deliveries: A Retrospective Study.Cureus · 2025Article
- Maternal and neonatal outcomes in full-term pregnancies of very advanced maternal age: a Japanese single-center retrospective cohort study.BMC pregnancy and childbirth · 2025Article
- Association of assisted reproductive technology with adverse maternal outcome: A cohort study.Pakistan journal of medical sciences · 2025Article
- Postpartum uterine atony complicating labor in a patient with systemic lupus erythematosus: A case report.SAGE open medical case reports · 2025Article
- Antepartum risk factors and outcomes of massive transfusion for elective cesarean section: a nationwide retrospective cohort study.BMC pregnancy and childbirth · 2024Article
- Quantitative and calculated estimated blood loss in cesarean deliveries for twin and singleton pregnancies: a retrospective analysis.Journal of anesthesia · 2024Article
- Maternal mortality due to obstetric hemorrhage by surgical injury during cesarean section: A nationwide study.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Risk Factors for Postpartum Hemorrhage in Severe Pre-Eclampsia: A Retrospective Single-Centre Study of 1953 Cases.Medical science monitor : international medical journal of experimental and clinical research · 2024Article
- Timely use of Bakri intrauterine balloon tamponade contributes to the effectiveness in controlling severe postpartum hemorrhage.Experimental and therapeutic medicine · 2024Article
- Is Grand Multiparity an Independent Risk Factor for Blood Transfusion?Reproductive sciences (Thousand Oaks, Calif.) · 2024Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundWomen who undergo intrapartum caesarean delivery (CD) are at increased risk of postpartum hemorrhage (PPH) compared with those undergoing prelabor CD. To determine whether the presence and strength of the associations between individual risk factors and severe PPH vary among women undergoing prelabor CD or intrapartum CD, stratified analyses are needed according to CD subtype.
methodsTo identify risk factors for severe PPH within 2 distinct CD populations, prelabor CD and intrapartum CD, we performed 2 case-control studies. Women in each study cohort delivered at a tertiary obstetric center in the United States between 2002 and 2012. For each study, cases were women who had a blood loss ≥1500 mL or who received an intraoperative or postoperative transfusion up to 48 hours after delivery. Risk factors for severe PPH among women undergoing prelabor CD or intrapartum CD were examined in separate logistic regression models.
resultsFor prelabor CD, we identified 269 cases and 550 controls. Clinical factors with the highest adjusted odds for severe PPH during prelabor CD were general anesthesia (adjusted odds ratio [aOR] = 22.3; 95% confidence interval [CI], 4.9-99.9; reference group = spinal anesthesia), multiple pregnancies (aOR = 8.0; 95% CI, 4.2-15.0; reference group = singleton pregnancy), and placenta previa (aOR = 6.3; 95% CI, 3.4-11.8). For intrapartum CD, we identified 278 cases and 572 controls. Clinical factors with the highest adjusted odds for severe PPH during intrapartum CD were general anesthesia (aOR = 5.4; 95% CI, 1.7-17.1), multiple pregnancies (aOR = 3.2; 95% CI, 1.7-6.3), and a predelivery hemoglobin ≤ 9.9 g/dL (aOR = 3.0; 95% CI, 1.3-6.9; reference group = predelivery hemoglobin ≥ 11 g/dL).
conclusionsWomen who undergo prelabor CD and intrapartum CD have several shared risk factors for severe PPH (general anesthesia and multiple pregnancies). However, the risk factor profiles for severe PPH differed between these CD cohorts. Recognizing these differences may be important when planning resources and interventions for high-risk patients undergoing either prelabor or intrapartum CD.
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