Postpartum hemorrhage risk is driven by changes in blood composition through pregnancy.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_BA8FC21210D4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Postpartum hemorrhage risk is driven by changes in blood composition through pregnancy.
Journal
Scientific reports
Author(s)
Robinson M.R., Patxot M., Stojanov M., Blum S., Baud D.
ISSN
2045-2322 (Electronic)
ISSN-L
2045-2322
Publication state
Published
Issued date
28/09/2021
Peer-reviewed
Oui
Volume
11
Number
1
Pages
19238
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
The extent to which women differ in the course of blood cell counts throughout pregnancy, and the importance of these changes to pregnancy outcomes has not been well defined. Here, we develop a series of statistical analyses of repeated measures data to reveal the degree to which women differ in the course of pregnancy, predict the changes that occur, and determine the importance of these changes for post-partum hemorrhage (PPH) which is one of the leading causes of maternal mortality. We present a prospective cohort of 4082 births recorded at the University Hospital, Lausanne, Switzerland between 2009 and 2014 where full labour records could be obtained, along with complete blood count data taken at hospital admission. We find significant differences, at a [Formula: see text] level, among women in how blood count values change through pregnancy for mean corpuscular hemoglobin, mean corpuscular volume, mean platelet volume, platelet count and red cell distribution width. We find evidence that almost all complete blood count values show trimester-specific associations with PPH. For example, high platelet count (OR 1.20, 95% CI 1.01-1.53), high mean platelet volume (OR 1.58, 95% CI 1.04-2.08), and high erythrocyte levels (OR 1.36, 95% CI 1.01-1.57) in trimester 1 increased PPH, but high values in trimester 3 decreased PPH risk (OR 0.85, 0.79, 0.67 respectively). We show that differences among women in the course of blood cell counts throughout pregnancy have an important role in shaping pregnancy outcome and tracking blood count value changes through pregnancy improves identification of women at increased risk of postpartum hemorrhage. This study provides greater understanding of the complex changes in blood count values that occur through pregnancy and provides indicators to guide the stratification of patients into risk groups.
Pubmed
Web of science
Open Access
Yes
Create date
04/10/2021 8:32
Last modification date
12/01/2022 7:13
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