Abstract

To examine postpartum haemorrhage (PPH) trends in Sweden using the Robson classification system.Population-based cohort study.Sweden.Deliveries 2000-2016, classified as Robson groups 1-5 (singleton pregnancies in vertex presentation, from week 37+0; n=1,590,178).We examined temporal trends in PPH between 2000 and 2016 overall and within each Robson group, and performed logistic regression to examine the influence of changes in risk factors (maternal, comorbidity, obstetric practice and infant factors) over time.PPH, defined as an estimated blood loss greater than 1000 ml.The overall PPH rate increased from 5.4% to 7.3%, corresponding to a 37% (OR: 1.37, 95% CI: 1.32-1.42) increase over time. Rates varied between Robson groups, ranging from 4.5% in group 3 to 14.3% in group 4b. Increasing trends in PPH were found in all Robson groups except for group 2b and 4b (prelabour caesarean deliveries). In the unstratified analysis, adjusting for maternal, comorbidity and obstetric practice factors slightly attenuated the risk of PPH in the later period (2013-16) compared with the reference period (2000-04; crude OR: 1.26, 95% CI: 1.24-1.29, adjusted OR: 1.22, 95% CI: 1.20-1.25). Within individual Robson groups, changes in risk factors did not explain increasing rates of PPH.PPH rates varied between Robson group. Changes in risk factors could not explain the 37% increase in PPH in women in Robson groups 1-5 in Sweden, 2000-2016.

View details for DOI 10.1111/1471-0528.16931

View details for PubMedID 34536326