Evidence map›Paper›PMID 34588243›Full record

Observational studyBMJ open2021

Incidence, trends and risk factors for obstetric massive blood transfusion in China from 2012 to 2019: an observational study.

Yanxia Xie, Juan Liang, Yi Mu, Zheng Liu, Yanping Wang, Li Dai, Xiaohong Li, Qi Li, Mingrong Li, Peiran Chen and 2 more

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.7field-weighted citation impact, top 10% 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

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
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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

12 authors at 1 institution in 1 country.

Yanxia XieNational Office for Maternal and Child Health Surveillance of China, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China.
Juan LiangNational Office for Maternal and Child Health Surveillance of China, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China.
Yi MuNational Office for Maternal and Child Health Surveillance of China, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China.
Zheng LiuNational Office for Maternal and Child Health Surveillance of China, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China.
Yanping WangNational Office for Maternal and Child Health Surveillance of China, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China.
Li DaiNational Office for Maternal and Child Health Surveillance of China, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China.
Xiaohong LiNational Office for Maternal and Child Health Surveillance of China, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China.
Qi LiNational Office for Maternal and Child Health Surveillance of China, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China.
Mingrong LiNational Office for Maternal and Child Health Surveillance of China, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China.
Peiran ChenNational Office for Maternal and Child Health Surveillance of China, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China.
Jun Zhu *National Office for Maternal and Child Health Surveillance of China, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China zhujun028@163.com drwangxiaodong@126.com.ORCID 0000-0001-9666-8010
Xiaodong Wang *Department of Obstetrics, Sichuan University West China Second University Hospital, Chengdu, Sichuan, China zhujun028@163.com drwangxiaodong@126.com.
Sichuan University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study aims to use the high-quality national monitoring data from the China's National Maternal Near Miss Surveillance System (NMNMSS) to ascertain the incidence, trends and risk factors of obstetric massive blood transfusion (MBT) from 2012 to 2019 in China and determine its clinical outcomes. SETTINGS: Observational study of hospitalised pregnancies who had given birth or ended their pregnancy among member hospitals of NMNMSS.

participants11 667 406 women were included in this study. PRIMARY AND SECONDARY OUTCOME MEASURES: We screened for the incidence, trends, risk factors and main reasons for obstetric MBT, and the outcomes after obstetric MBT. MBT was defined as the transfusion of ≥5 units of red blood cells or ≥1000 mL of whole blood. The incidence of MBT was defined as the MBT cases per 10 000 pregnancies.

resultsObstetric MBT occurred in 27 626 cases, corresponding to an incidence of 23.68 per 10 000 maternities, which exhibited an increasing trend in China during 2012-2019 (14.03-29.59 per 10 000 maternities, p for trend <0.001). Obstetric MBT was mainly associated with amniotic fluid embolism, uterine atony, abnormal placenta, severe anaemia, ectopic pregnancy, abortion, caesarean section, advanced maternal age and multiparous from biological effect. While from sociological effects, uterine atony, severe anaemia and placenta previa are the top three complications which more likely to undergo obstetric MBT in the Chinese population. Overall, the secular trends of hysterectomy incidence (25.07%-9.92%) and MMR during hospitalisation (21.41‰-7.48‰) among women who underwent MBT showed decreasing trends (p for trend <0.001).

conclusionTo minimise the incidence of obstetric MBT, more attention should be paid to education on the importance of the antenatal visit, evidence-based transfusion practice and females who are multiparous and have an advanced age, amniotic fluid embolism, uterine atony, severe anaemia and placenta previa.

Indexed as

Cesarean SectionPostpartum HemorrhageBlood TransfusionChinaFemaleHumansHysterectomyIncidencePregnancyRisk Factorsfetal medicinematernal medicinepublic health

Identifiers

PMID34588243
PMCPMC8479942
OpenAlexW3203232279

What OpenQuestion holds

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LicenceCC BY-NC
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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.