Association between anesthetic method and postpartum hemorrhage in Korea based on National Health Insurance Service data
Background Postpartum hemorrhage (PPH) is a major cause of maternal mortality and the risk factors for PPH differ among studies. In this large-scale study, we investigated whether the anesthetic method used was associated with PPH after cesarean section. Methods We extracted data on cesarean section...
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2022-04-01
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| Series: | Anesthesia and Pain Medicine |
| Subjects: | |
| Online Access: | http://www.anesth-pain-med.org/upload/pdf/apm-21068.pdf |
| _version_ | 1797825410632777728 |
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| author | Yongho Jee Hyun Jung Lee Youn Jin Kim Dong Yeon Kim Jae Hee Woo |
| author_facet | Yongho Jee Hyun Jung Lee Youn Jin Kim Dong Yeon Kim Jae Hee Woo |
| author_sort | Yongho Jee |
| collection | DOAJ |
| description | Background Postpartum hemorrhage (PPH) is a major cause of maternal mortality and the risk factors for PPH differ among studies. In this large-scale study, we investigated whether the anesthetic method used was associated with PPH after cesarean section. Methods We extracted data on cesarean sections performed between January 2008 and June 2013 from the National Health Insurance Service database. The anesthetic methods were categorized into general, spinal and epidural anesthesia. To compare the likelihood of PPH among deliveries using different anesthetic methods, crude and adjusted odds ratios (ORs) and 95% confidence intervals were calculated using logistic regression analysis. Results Data from 330,324 cesarean sections were analyzed, and 21,636 cases of PPH were identified. Univariate analysis showed that general and epidural anesthesia increased the risk of PPH compared to spinal anesthesia. The OR for PPH was highest for morbidly adherent placenta, followed by placenta previa, placental abruption, and hypertension. When other clinical covariates were controlled for, general and epidural anesthesia still remained significant risk factors for PPH compared to spinal anesthesia. Conclusions This study showed that general and epidural anesthesia elevated the risk of PPH compared to spinal anesthesia during cesarean section. Since we could not consider the potential bias of group differences in indications, more in-depth clinical trials are needed to validate our findings. Obstetric factors such as placental abnormalities had high odds ratios and thus are more important than the choice of anesthetic method, which should be based on the patient’s clinical condition and institutional resources. |
| first_indexed | 2024-03-13T10:53:38Z |
| format | Article |
| id | doaj.art-ada7be98d4ea43a8aaf2bf930054e434 |
| institution | Directory Open Access Journal |
| issn | 1975-5171 2383-7977 |
| language | English |
| last_indexed | 2024-03-13T10:53:38Z |
| publishDate | 2022-04-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Anesthesia and Pain Medicine |
| spelling | doaj.art-ada7be98d4ea43a8aaf2bf930054e4342023-05-17T05:57:13ZengKorean Society of AnesthesiologistsAnesthesia and Pain Medicine1975-51712383-79772022-04-0117216517210.17085/apm.210681115Association between anesthetic method and postpartum hemorrhage in Korea based on National Health Insurance Service dataYongho Jee0Hyun Jung Lee1Youn Jin Kim2Dong Yeon Kim3Jae Hee Woo4 Advanced Biomedical Research Institute, Ewha Womans University Seoul Hospital, Seoul, Korea Department of Anesthesiology and Pain Medicine, Ewha Womans University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Ewha Womans University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Ewha Womans University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Ewha Womans University College of Medicine, Seoul, KoreaBackground Postpartum hemorrhage (PPH) is a major cause of maternal mortality and the risk factors for PPH differ among studies. In this large-scale study, we investigated whether the anesthetic method used was associated with PPH after cesarean section. Methods We extracted data on cesarean sections performed between January 2008 and June 2013 from the National Health Insurance Service database. The anesthetic methods were categorized into general, spinal and epidural anesthesia. To compare the likelihood of PPH among deliveries using different anesthetic methods, crude and adjusted odds ratios (ORs) and 95% confidence intervals were calculated using logistic regression analysis. Results Data from 330,324 cesarean sections were analyzed, and 21,636 cases of PPH were identified. Univariate analysis showed that general and epidural anesthesia increased the risk of PPH compared to spinal anesthesia. The OR for PPH was highest for morbidly adherent placenta, followed by placenta previa, placental abruption, and hypertension. When other clinical covariates were controlled for, general and epidural anesthesia still remained significant risk factors for PPH compared to spinal anesthesia. Conclusions This study showed that general and epidural anesthesia elevated the risk of PPH compared to spinal anesthesia during cesarean section. Since we could not consider the potential bias of group differences in indications, more in-depth clinical trials are needed to validate our findings. Obstetric factors such as placental abnormalities had high odds ratios and thus are more important than the choice of anesthetic method, which should be based on the patient’s clinical condition and institutional resources.http://www.anesth-pain-med.org/upload/pdf/apm-21068.pdfanesthesia, epiduralanesthesia, generalanesthesia, spinalpostpartum hemorrhage |
| spellingShingle | Yongho Jee Hyun Jung Lee Youn Jin Kim Dong Yeon Kim Jae Hee Woo Association between anesthetic method and postpartum hemorrhage in Korea based on National Health Insurance Service data Anesthesia and Pain Medicine anesthesia, epidural anesthesia, general anesthesia, spinal postpartum hemorrhage |
| title | Association between anesthetic method and postpartum hemorrhage in Korea based on National Health Insurance Service data |
| title_full | Association between anesthetic method and postpartum hemorrhage in Korea based on National Health Insurance Service data |
| title_fullStr | Association between anesthetic method and postpartum hemorrhage in Korea based on National Health Insurance Service data |
| title_full_unstemmed | Association between anesthetic method and postpartum hemorrhage in Korea based on National Health Insurance Service data |
| title_short | Association between anesthetic method and postpartum hemorrhage in Korea based on National Health Insurance Service data |
| title_sort | association between anesthetic method and postpartum hemorrhage in korea based on national health insurance service data |
| topic | anesthesia, epidural anesthesia, general anesthesia, spinal postpartum hemorrhage |
| url | http://www.anesth-pain-med.org/upload/pdf/apm-21068.pdf |
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