Meta-analysis to assess the role of maternal characteristics and risk factors on postpartum hemorrhage

Abstract

Background. Postpartum hemorrhage (PPH) is a serious condition that can lead to several complications. Many different factors precipitate PPH. Objectives. To assess the role and impact of different factors such as body mass index (BMI), age, hypertension, parity, and embryo transfer on PPH. Materials and methods. Thirty-one studies have been included in the current meta-analysis. The outcomes of these studies were analyzed using a random-effects model and it was used to calculate the mean difference (MD) with 95% confidence interval (95% CI) in order to quantify the impact of different risk factors on PPH. Results. Regarding the maternal age, older subjects (≥35 years) showed a significantly higher incidence of PPH (MD = 1.15, 95% CI: 1.03–1.27, p = 0.01). On the other hand, BMI had no impact on the incidence of PPH (MD = 0.76, 95% CI: 0.26–2.24, p = 0.62). At the same time, primiparous subjects, those with hypertension and those in whom frozen–thawed embryo transfer (FTET) was performed showed a significantly higher PPH incidence (MD = 1.27, 95% CI: 1.02–1.56, p = 0.03; MD = 1.51, 95% CI: 1.42–1.61, p < 0.001; and MD = 1.43, 95% CI: 1.11–1.85, p = 0.006, respectively). Conclusions. The weight of the subjects is not a risk factor for PPH. However, a higher incidence of the disease can be observed in older, hypertensive and primiparous subjects, as well as those in whom FTET performed.