ArticleMaternal-fetal medicine (Wolters Kluwer Health, Inc.)2026
Risk Factors for Severe Postpartum Hemorrhage in Vaginal Delivery: A Retrospective Cohort Study.
Article in Maternal-fetal medicine (Wolters Kluwer Health, Inc.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To investigate the risk factors for severe postpartum hemorrhage (SPPH) in vaginal delivery and explore targeted prediction and prevention strategies. Methods: A retrospective cohort study of singleton pregnancies with vaginal deliveries after 28 weeks of gestation from January 1, 2021, to December 31, 2024, in the Peking Union Medical College Hospital was conducted. Women with multiple pregnancies, those with gestational age less than 28 weeks, and those giving birth through cesarean section were excluded. The primary outcome was SPPH, defined as blood loss of 1000 mL or more within 24 h of childbirth, or the presence of signs or symptoms of low blood volume requiring a transfusion of four or more units of red blood cells. Multivariate logistic regression was used to identify potential risk factors for SPPH. Results: A total of 6784 women were included in the study, with a SPPH rate of 1.31%. Low-lying placenta or placenta previa (adjusted odds ratio (a Conclusion: Placenta-related factors (placenta accreta spectrum, low-lying placenta, or placenta previa), thrombocytopenia, episiotomy, and precipitate labor were identified as factors potentially associated with SPPH in vaginal delivery. These findings should be interpreted with caution, given the limited number of events, and further validation through larger, multicenter studies is warranted.
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