Trends in postpartum hemorrhage: United States, 1994-2006
Trends in postpartum hemorrhage: United States, 1994-2006
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DOI：
10.1016/j.ajog.2010.01.011
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发表时间：
2010-04-01
影响因子：
9.8
通讯作者：
Berg, Cynthia J.
中科院分区：
文献类型：
--
作者：
Callaghan, William M.;Kuklina, Elena V.;Berg, Cynthia J.
目的：本研究的目的是估计美国产后出血（PPH）的发生率并评估其趋势。研究设计：采用1994-2006年全国住院患者样本的基于人群的数据来确定因产后出血住院的妇女。绘制了每年的数据，并评估了趋势。采用多变量logistic回归试图解释1994年至2006年间PPH发病率的差异。结果：PPH从1994年的2.3% （n = 85,954）上升到2006年的2.9% (n = 124,708; P < .001)，增幅为26%。增加主要是由于子宫张力的增加，从1.6% （n = 58,597）增加到2.4% （n = 99,904; P < .001）。PPH升高不能用剖宫产率、剖宫产后顺产率、产妇年龄、多胎、高血压或糖尿病的变化来解释。结论：基于人群的监测数据表明子宫张力不全引起的PPH明显增加。需要更多细致入微的临床数据来了解与这一趋势相关的因素。
OBJECTIVE: The purpose of this study was to estimate the incidence of postpartum hemorrhage (PPH) in the United States and to assess trends.STUDY DESIGN: Population-based data from the 1994-2006 National Inpatient Sample were used to identify women who were hospitalized with postpartum hemorrhage. Data for each year were plotted, and trends were assessed. Multivariable logistic regression was used in an attempt to explain the difference in PPH incidence between 1994 and 2006.RESULTS: PPH increased 26% between 1994 and 2006 from 2.3% (n = 85,954) to 2.9% (n = 124,708; P < .001). The increase primarily was due to an increase in uterine atony, from 1.6% (n = 58,597) to 2.4% (n = 99,904; P < .001). The increase in PPH could not be explained by changes in rates of cesarean delivery, vaginal birth after cesarean delivery, maternal age, multiple birth, hypertension, or diabetes mellitus.CONCLUSION: Population-based surveillance data signal an apparent increase in PPH caused by uterine atony. More nuanced clinical data are needed to understand the factors that are associated with this trend.