Evidence map›Paper›PMID 29346134›Full record

ArticleAnesthesiology2018

Effect of Maternal Body Mass Index on Postpartum Hemorrhage.

Alexander J Butwick, Anisha Abreo, Brian T Bateman, Henry C Lee, Yasser Y El-Sayed, Olof Stephansson, Pamela Flood

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Anesthesiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 2 pooled it
12.0field-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.

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

39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 94 citations in OpenAlex.

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  5. Neutrophil-to-lymphocyte ratio at admission helps to predict the need for blood transfusion after vaginal delivery.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

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

7 authors at 1 institution in 1 country.

Alexander J ButwickFrom the Department of Anesthesiology, Perioperative, and Pain Medicine (A.J.B., P.F.), the Division of Neonatal and Developmental Medicine (H.C.L.), the Department of Obstetrics and Gynecology (Y.Y.E-S.), Stanford University School of Medicine, Stanford, California; the California Maternal Quality Care Collaborative, Medical School Office Building, Stanford, California (A.A.); the Department of Anesthesiology, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts (B.T.B.); the Department of Medicine Solna, Clinical Epidemiology Unit, and the Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden (O.S.).
Anisha Abreo
Brian T Bateman
Henry C Lee
Yasser Y El-Sayed
Olof Stephansson
Pamela Flood
Stanford Medicine · US

Funding

Spectrum Stanford Center for clinical and Translational Research and EducationUL1TR001085 · NCATS · STANFORD UNIVERSITY · PI CULLEN, MARK RICHARD, GREENBERG, HARRY BERNARD · 2013 to 2017
$37.1M
Postpartum Hemmorrhage and Anemia: Epidemiologic and Cost-Effectiveness AnalysesK23HD070972 · NICHD · STANFORD UNIVERSITY · PI BUTWICK, ALEXANDER JAMES · 2013 to 2017
$699k
NCATS NIH HHS UL1 TR001085NICHD NIH HHS K23 HD070972
6 · The paper itself

Abstract

backgroundIt is unclear whether obesity is a risk factor for postpartum hemorrhage. The authors hypothesized that obese women are at greater risk of hemorrhage than women with a normal body mass index.

methodsThe authors conducted a cohort study of women who underwent delivery hospitalization in California between 2008 and 2012. Using multilevel regression, the authors examined the relationships between body mass index with hemorrhage (primary outcome), atonic hemorrhage, and severe hemorrhage (secondary outcomes). Stratified analyses were performed according to delivery mode.

resultsThe absolute event rate for hemorrhage was 60,604/2,176,673 (2.8%). In this cohort, 4% of women were underweight, 49.1% of women were normal body mass index, 25.9% of women were overweight, and 12.7%, 5.2%, and 3.1% of women were in obesity class I, II, and III, respectively. Compared to normal body mass index women, the odds of hemorrhage and atonic hemorrhage were modestly increased for overweight women (hemorrhage: adjusted odds ratio [aOR], 1.06; 99% CI, 1.04 to 1.08; atonic hemorrhage: aOR, 1.07; 99% CI, 1.05 to 1.09) and obesity class I (hemorrhage: aOR, 1.08; 99% CI, 1.05 to 1.11; atonic hemorrhage; aOR, 1.11; 99% CI, 1.08 to 1.15). After vaginal delivery, overweight and obese women had up to 19% increased odds of hemorrhage or atonic hemorrhage; whereas, after cesarean delivery, women in any obesity class had up to 14% decreased odds of severe hemorrhage.

conclusionsThe authors' findings suggest that, at most, maternal obesity has a modest effect on hemorrhage risk. The direction of the association between hemorrhage and body mass index may differ by delivery mode.

Indexed as

Body Mass IndexMaternal HealthAdolescentAdultCohort StudiesFemaleHumansObesityOverweightPostpartum HemorrhagePregnancyRetrospective StudiesYoung Adult

Identifiers

PMID29346134
PMCPMC5849500
OpenAlexW2784236738

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.