The incidence and risk factors of postpartum haemorrhage in a low resource setting

This was a retrospective study to investigate the incidence and identify risk factors of Postpartum Haemorrhage (PPH) in women attended to at Mpilo Central Hospital in Bulawayo, Zimbabwe during January 2017 – June 2018.
Postpartum haemorrhage(PPH), as defined by the World Health Organisation (WHO), is vaginal blood loss in excess of 500ml following childbirth. Primary PPH is defined as blood loss of 500ml or more following a normal vaginal delivery (NVD) or 1,000ml or more following a Caesarean section, within 24 hours of birth.

Logistic regression models were used to determine the association and interaction patterns among the variables, when identifying the risk factors, using the statistical software SPSS. Categorical data analysis will be carried out in SPSS, to develop a regression model for the likelihood to develop PPH.

The predictor variables were age, gestational age, antenatal booking status, past obstetrics complications, parity, current complications and birth weight. Univariate analysis was done to determine the risk factors. Each independent variable was
regressed against the dependent variable to test for significance for inclusion in the final model. The incidence rate was 1.66%, much less than is reported in literature for sub Saharan countries. The regression equation showed that for PPH (LSCS) relative to PPH (NVD), there was only one predictor (ENND1=0), with a regression coefficient significantly from zero so it was included in the final model. It shows that the relative log odds of being in PPH (LSCS) relative to PPH (NVD) would decrease by -3.969 if changing from (ENND1=1) to (ENND1 = 0).

本研究是一项回顾性研究，旨在调查在津巴布韦布隆迪的Mpilo中央医院接受治疗的妇女在2017年1月至2018年6月期间产后出血（PPH）的发病率，并识别其风险因素。根据世界卫生组织（WHO）的定义，产后出血（PPH）是指产后阴道出血量超过500毫升。原发性PPH是指在正常阴道分娩（NVD）后出血量达到或超过500毫升，或在剖宫产术后24小时内出血量达到或超过1000毫升。使用统计软件SPSS中的逻辑回归模型，本研究确定了变量之间的关联和交互模式，以识别风险因素。将进行分类数据分析，以在SPSS中构建一个PPH发生可能性的回归模型。预测变量包括年龄、孕周、产前登记状态、既往产科并发症、产次、当前并发症和出生体重。进行单变量分析以确定风险因素。每个独立变量都与因变量进行回归分析，以检验其显著性，从而决定是否包含在最终模型中。发病率率为1.66%，远低于撒哈拉以南国家文献中的报道。回归方程显示，与PPH（剖宫产）相比，PPH（NVD）的相对对数几率降低-3.969，这表明当从（ENND1=1）变为（ENND1=0）时，PPH（LSCS）相对于PPH（NVD）的相对对数几率将降低。