The association between body mass index and postpartum hemorrhage after cesarean delivery

Abstract We aimed to evaluate the association between obesity and postpartum hemorrhage (PPH) after cesarean delivery (CD). This was a retrospective cohort study using a multicenter database of 20 hospitals in the United States. We analyzed 27,708 patients undergoing CD from 2015 to 2019. The exposu...

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Main Authors: Julia Whitley, Wayde Dazelle, Shawn Kripalani, Homa Ahmadzia
Format: Article
Language:English
Published: Nature Portfolio 2023-07-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-023-38526-7
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author Julia Whitley
Wayde Dazelle
Shawn Kripalani
Homa Ahmadzia
author_facet Julia Whitley
Wayde Dazelle
Shawn Kripalani
Homa Ahmadzia
author_sort Julia Whitley
collection DOAJ
description Abstract We aimed to evaluate the association between obesity and postpartum hemorrhage (PPH) after cesarean delivery (CD). This was a retrospective cohort study using a multicenter database of 20 hospitals in the United States. We analyzed 27,708 patients undergoing CD from 2015 to 2019. The exposure of interest was BMI, and the primary outcome was PPH (estimated blood loss [EBL] ≥ 1000 mL). Simple logistic regression was used to evaluate the relationship between obesity and intrapartum complications. Multivariable logistic regression was used to adjust for any confounding demographic variables. Hosmer and Lemeshow’s purposeful selection algorithm was adapted to develop a multivariable logistic regression model of PPH. Analyses were conducted using STATA 16.1 (College Station, Texas) with p ≤ 0.05 considered significant. BMI exerted a significant effect on the frequency of PPH (p = 0.004). Compared to patients with BMI 18.5–24.9 kg/m2, patients with BMI between 25 and 59.9 kg/m2 had an increased odds of PPH. The odds of PPH in patients with BMI > 60 kg/m2 was not increased compared to patients with BMI 18.5–24.9 kg/m2. Obesity was associated with a decreased odds of blood transfusion (aOR 0.73, 95% CI 0.55–0.97). In conclusion, higher BMI was associated with PPH yet a lower odds of transfusion after CD.
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spelling doaj.art-89e44448108c4b7b8e5ceb7d2959a13c2023-07-30T11:11:35ZengNature PortfolioScientific Reports2045-23222023-07-011311810.1038/s41598-023-38526-7The association between body mass index and postpartum hemorrhage after cesarean deliveryJulia Whitley0Wayde Dazelle1Shawn Kripalani2Homa Ahmadzia3Department of Obstetrics and Gynecology, George Washington University School of Medicine and Health SciencesDepartment of Obstetrics and Gynecology, George Washington University School of Medicine and Health SciencesDepartment of Obstetrics and Gynecology, George Washington University School of Medicine and Health SciencesDepartment of Obstetrics and Gynecology, George Washington University School of Medicine and Health SciencesAbstract We aimed to evaluate the association between obesity and postpartum hemorrhage (PPH) after cesarean delivery (CD). This was a retrospective cohort study using a multicenter database of 20 hospitals in the United States. We analyzed 27,708 patients undergoing CD from 2015 to 2019. The exposure of interest was BMI, and the primary outcome was PPH (estimated blood loss [EBL] ≥ 1000 mL). Simple logistic regression was used to evaluate the relationship between obesity and intrapartum complications. Multivariable logistic regression was used to adjust for any confounding demographic variables. Hosmer and Lemeshow’s purposeful selection algorithm was adapted to develop a multivariable logistic regression model of PPH. Analyses were conducted using STATA 16.1 (College Station, Texas) with p ≤ 0.05 considered significant. BMI exerted a significant effect on the frequency of PPH (p = 0.004). Compared to patients with BMI 18.5–24.9 kg/m2, patients with BMI between 25 and 59.9 kg/m2 had an increased odds of PPH. The odds of PPH in patients with BMI > 60 kg/m2 was not increased compared to patients with BMI 18.5–24.9 kg/m2. Obesity was associated with a decreased odds of blood transfusion (aOR 0.73, 95% CI 0.55–0.97). In conclusion, higher BMI was associated with PPH yet a lower odds of transfusion after CD.https://doi.org/10.1038/s41598-023-38526-7
spellingShingle Julia Whitley
Wayde Dazelle
Shawn Kripalani
Homa Ahmadzia
The association between body mass index and postpartum hemorrhage after cesarean delivery
Scientific Reports
title The association between body mass index and postpartum hemorrhage after cesarean delivery
title_full The association between body mass index and postpartum hemorrhage after cesarean delivery
title_fullStr The association between body mass index and postpartum hemorrhage after cesarean delivery
title_full_unstemmed The association between body mass index and postpartum hemorrhage after cesarean delivery
title_short The association between body mass index and postpartum hemorrhage after cesarean delivery
title_sort association between body mass index and postpartum hemorrhage after cesarean delivery
url https://doi.org/10.1038/s41598-023-38526-7
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