{"id":13166,"date":"2023-03-09T00:00:00","date_gmt":"2023-03-09T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/publications\/journal-articles\/identifying-the-effect-of-inherited-bleeding-disorders-on-the-development-of-postpartum-hemorrhage-a-population-based-retrospective-cohort-study\/"},"modified":"2023-07-21T15:32:14","modified_gmt":"2023-07-21T19:32:14","slug":"identifying-the-effect-of-inherited-bleeding-disorders-on-the-development-of-postpartum-hemorrhage","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/identifying-the-effect-of-inherited-bleeding-disorders-on-the-development-of-postpartum-hemorrhage\/","title":{"rendered":"Identifying the effect of inherited bleeding disorders on the development of postpartum hemorrhage: a population-based, retrospective cohort study"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Women with inherited bleeding disorders (IBD) have an increased risk of postpartum hemorrhage (PPH). However, the impact of other maternal pre-delivery risk factors, including anemia, on the association between IBD and maternal bleeding remains poorly understood. Additionally, studies examining potential pathways linking IBD and PPH are limited.<\/p>\n<p><strong>Objective<\/strong> \u2014 To determine the risk of PPH associated with IBD.<\/p>\n<p><strong>Methods<\/strong> \u2014 A retrospective cohort study was conducted using data held within ICES (formerly: the Institute for Clinical Evaluative Sciences). Women with an in-hospital, live or stillborn delivery, between January 2014 and December 2019 were included. Poisson regression with robust error variance was used to determine risk (RR) and 95% confidence intervals (CIs) of PPH among women with or without an IBD diagnosis. Models were stratified for primiparous and multiparous women.<\/p>\n<p><strong>Results<\/strong> \u2014 Among the total population of 601,773 women, 29,661 (4.93%) experienced PPH. Multivariate models demonstrated that IBD was an independent risk factor for PPH among both the total cohort (adjusted RR [aRR] = 1.26, 95% CI 1.08,1.46) and primiparous women (aRR = 1.36, 95% CI 1.12, 1.66). Among multiparous women, prior PPH was associated with increased risk of PPH (aRR = 8.65, 95% CI 8.32, 8.99) while IBD had no effect (aRR = 1.1, 95% CI 0.86, 1.4). Pre-delivery anemia, placental conditions, multifetal gestation, and induction of labour were associated with increased PPH risk among all cohorts.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 IBD significantly increases the risk of PPH. Management of delivery should be based on individualized assessment of risk factors to ensure optimal maternal outcomes.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Women with inherited bleeding disorders (IBD) have an increased risk of postpartum hemorrhage (PPH). However, the impact of other maternal pre-delivery risk factors, including anemia, on the association between IBD and maternal bleeding remains poorly understood. Additionally, studies examining potential pathways linking IBD and PPH are limited. Objective \u2014 To determine the risk [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[47,26],"migration-helper-qa-sample-set":[],"class_list":["post-13166","journal_article","type-journal_article","status-publish","hentry","topic-hematology","topic-maternity-and-neonatal-care"],"acf":{"citation":"Hews-Girard JC, Galica J, Goldie C, James P, Tranmer JE. <em>Res Pract Thromb Haemost<\/em>. 2023; Mar 9 [Epub ahead of print].","source_url":"https:\/\/www.rpthjournal.org\/article\/S2475-0379(23)00073-0\/fulltext","ices_scientist":[1110],"site":[6736],"research_program":[6747],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"C191556E-93FA-493F-9F5C-468E843673D0","sitecore_item_name":"Identifying-the-effect-of-inherited-bleeding-disorders-on-the-development-of-postpartum-hemorrhage","sitecore_field_values":"{\r\n  \"Title\": \"Identifying the effect of inherited bleeding disorders on the development of postpartum hemorrhage: a population-based, retrospective cohort study\",\r\n  \"Short title\": \"Identifying the effect of inherited\",\r\n  \"Summary\": \"The study aim was to determine the risk of postpartum hemorrhage associated with inherited bleeding disorders.\",\r\n  \"Citation\": \"<p>Hews-Girard JC, Galica J, Goldie C, James P, Tranmer JE. <em>Res Pract Thromb Haemost<\/em>. 2023; Mar 9 [Epub ahead of print]. DOI: <a href=\"https:\/\/doi.org\/10.1016\/j.rpth.2023.100104\" title=\"opens external link\">https:\/\/doi.org\/10.1016\/j.rpth.2023.100104<\/a><\/p>\",\r\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; Women with inherited bleeding disorders (IBD) have an increased risk of postpartum hemorrhage (PPH). However, the impact of other maternal pre-delivery risk factors, including anemia, on the association between IBD and maternal bleeding remains poorly understood. Additionally, studies examining potential pathways linking IBD and PPH are limited.<\/p>n<p><strong>Objective<\/strong> &mdash; To determine the risk of PPH associated with IBD.<\/p>n<p><strong>Methods<\/strong> &mdash; A retrospective cohort study was conducted using data held within ICES (formerly: the Institute for Clinical Evaluative Sciences). Women with an in-hospital, live or stillborn delivery, between January 2014 and December 2019 were included. Poisson regression with robust error variance was used to determine risk (RR) and 95% confidence intervals (CIs) of PPH among women with or without an IBD diagnosis. Models were stratified for primiparous and multiparous women.<\/p>n<p><strong>Results<\/strong> &mdash; Among the total population of 601,773 women, 29,661 (4.93%) experienced PPH. Multivariate models demonstrated that IBD was an independent risk factor for PPH among both the total cohort (adjusted RR [aRR] = 1.26, 95% CI 1.08,1.46) and primiparous women (aRR = 1.36, 95% CI 1.12, 1.66). Among multiparous women, prior PPH was associated with increased risk of PPH (aRR = 8.65, 95% CI 8.32, 8.99) while IBD had no effect (aRR = 1.1, 95% CI 0.86, 1.4). Pre-delivery anemia, placental conditions, multifetal gestation, and induction of labour were associated with increased PPH risk among all cohorts.<\/p>n<p><strong>Conclusions<\/strong> &mdash; IBD significantly increases the risk of PPH. Management of delivery should be based on individualized assessment of risk factors to ensure optimal maternal outcomes.<\/p>n<p><a href=\"https:\/\/www.rpthjournal.org\/article\/S2475-0379(23)00073-0\/fulltext\" title=\"opens external link\">View full text<\/a><\/p>\",\r\n  \"ICES Scientists\": \"{7C038BB7-E562-448D-9279-D6A687691769}\",\r\n  \"Posted Date\": \"20230309T000000\",\r\n  \"Show on Publications Landing Page\": \"1\"\r\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2023\/March\/Identifying-the-effect-of-inherited-bleeding-disorders-on-the-development-of-postpartum-hemorrhage"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Identifying the effect of inherited bleeding disorders on the development of postpartum hemorrhage: a population-based, retrospective cohort study<\/title>\n<meta name=\"description\" content=\"Background \u2014 Women with inherited bleeding disorders (IBD) have an increased risk of postpartum hemorrhage (PPH). 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