Factors Affecting the Risk of Postpartum Hemorrhage in Pregnant Women in Tibet Health Facilities

BACKGROUND: Postpartum hemorrhage (PPH), the leading cause of maternal death, is defined as a blood loss >500 mL within 24 h after vaginal delivery or >1000 mL within 24 h after cesarean section. This study aimed to investigate the incidence of PPH and assess its risk factors in pregnant women in Tibet to provide a reference for clinicians in this region. MATERIAL/METHODS: A total of 4796 pregnant women with gestational age ≥28 weeks who were admitted to hospitals in Tibet between December 2010 and December 2016 were involved in this study. Patient sociological and clinical data and pregnancy outcomes were collected. The related risk factors of PPH were analyzed by univariate and multivariable logistic regression. The area under the curve of the receiver operating characteristic curves was used to evaluate the effect of the PPH prediction model. RESULTS: PPH occurred in 95 women, with an incidence of 1.98%. The following factors were associated with higher risk for PPH: maternal age ≥35 (odds ratio [OR]=1.96; 95% confidence interval [CI], 1.18–3.27; P=0.010), history of preterm birth (OR=2.66; 95% CI, 1.60–4.42; P<0.001), cesarean section (OR=6.69; 95% CI, 4.30–10.40; P<0.001), neonatal weight >4 kg (OR=3.92; 95% CI, 1.75–8.81; P<0.001) and occurrence of neonatal asphyxia (OR=5.52; 95% CI, 2.22–13.74; P<0.001). CONCLUSIONS: Maternal age ≥35, history of preterm birth, cesarean section, newborn weight >4 kg, and neonatal asphyxia were risk factors of PPH, which can help evaluate PPH in Tibet.