Factors Associated with Postpartum Hemorrhage in Central Java


Siti Nur Hidayati1), Uki Retno Budihastuti2), Vitri Widyaningsih3)

 

1)Masters Program in Public Health, Universitas Sebelas Maret

2)Department of Obstetrics and Gynecology, Dr. Moewardi Hospital

3)Faculty of Medicine, Universitas Sebelas Maret

 

ABSTRACT

Background: Postpartum hemorrhage (PPH) remains the leading cause of maternal mortality worldwide. Prenatal identification of at risk women, prompt assessment of blood loss, effective management, and involvement of multidisciplinary teams is important to reduce the risk maternal mortality. This study aimed to determine factors associated with postpartum hemorrhage in Central Java.

Subjects and Method: This was a case control study carried out at Dr. Moewardi hospital, Surakarta, from April to May 2019. A sample of 225 postpartum mothers was selected by fixed disease sampling. The dependent variable was postpartum hemorrhage. The independent variables were birth spacing, atonia uteri, obstetrics history, preeclampsia, premature rupture of membranes, placenta retention, vaginal laceration, type of labor, prolonged labor, uterine over-distension, and anemia. The data were obtained from medical record and analyzed by a multiple logistic regression.

Results: Birth spacing <2 years (b= 2.03; 95%CI= 0.39 to 3.67; p= 0.015), uterine atonia (b= 2.42; 95%CI= 0.79 to 4.06; p= 0.004), poor obstetrics history (b= 1.41; 95% CI= 0.16 to 2.66; p= 0.026), preeclampsia (b= 1.74; 95%CI= 0.37 to 3.11; p= 0.012), premature rupture of membranes (b= 2.01; 95%CI= 0.66 to 3.36; p= 0.003), placenta retention (b= 4.22; 95%CI= 2.86 to 5.57; p<0.001), vaginal laceration (b= 2.15; 95% CI= 0.58 to 3.72; p= 0.007), assisted labor (b= 2.17; 95%CI= 0.97 to 3.37; p<0.001), prolonged labor (b= 2.26; 95%CI= 0.59 to 3.92; p= 0.008), uterine over-distension (b= 2.59; 95%CI= 0.07 to 5.11; p= 0.044), and anemia (b= 2.29; 95%CI= 1.10 to 3.47; p<0.001) increased the risk of postpartum hemorrhage.

Conclusion: Birth spacing <2 years, uterine atonia, poor obstetrics history, preeclampsia, premature rupture of membranes, placenta retention, vaginal laceration, assisted labor, prolonged labor, uterine over-distension, and anemia increase the risk of postpartum hemorrhage.

Keywords: postpartum bleeding, placenta retention, atonia uteri

Correspondence: Siti Nur Hidayati. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: sitihidayati58@gmail.com. Mobile: 082133679586.

DOI: https://doi.org/10.26911/the6thicph.03.21

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