Risk factors for blood transfusion in singleton pregnancy deliveries in Taiwan

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• 作者：Hei-Jen Jou^a ; ^b ; Hsin-Wen Hung^c ; Yuan-Horng Yan^c ; Shiao-Chi Wu^d ; ^{scwu@ym.edu.tw}
• 关键词：Blood transfusion ; Cesarean delivery ; Vaginal birth after cesarean ; Vaginal delivery
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：2012
• 期刊代码：130_00207292
• 类别：med
• 出版时间：May, 2012
• 卷：117
• 期：2
• 页码：124-127
• 文件大小：192 K

摘要

Objective

To investigate risk factors for blood transfusion in pregnancy.

Methods

In a population-based study, data from all women with singleton pregnancies (n = 225 304) admitted for delivery in Taiwanese hospitals in 2002 were obtained from the National Health Insurance claims database. To identify risk factors for blood transfusion, a logistic regression model with generalized estimating equation was used to calculate the adjusted odds ratio (OR) and 95%confidence intervals (CI) for characteristics of the pregnant women, hospitals, clinics, and obstetricians.

Results

The incidence of blood transfusion was 1.43%. Cesarean delivery, vaginal birth after cesarean (VBAC), and repeat cesarean delivery had higher rates of blood transfusion than vaginal delivery, with an OR of 7.2 (95%CI, 6.38-8.02), 4.2 (95%CI, 2.52-6.87), and 5.9 (95%CI, 5.06-6.80), respectively. Other risk factors included extremes of age; pregnancies complicated by prepartum hemorrhage, placenta previa, pre-eclampsia, eclampsia, anemia, or systemic lupus erythematosus; and obstetricians with low or mid-to-low numbers of deliveries.

Conclusion

The study has identified risk factors for blood transfusion in pregnancy on the basis of a nationwide database and provides useful information for obstetric practice. For women with a history of cesarean delivery, vaginal delivery might be considered owing to its lower incidence of transfusion.