Increased postpartum hemorrhage rates in Australia

Int J Gynaecol Obstet. 2007 Sep;98(3):237-43. doi: 10.1016/j.ijgo.2007.03.011. Epub 2007 May 4.


Objective: To determine whether changes in risk factors for postpartum hemorrhage (PPH) over time are associated with a rise in postpartum hemorrhage rates.

Methods: Population-based study using linked hospital discharge and birth records from New South Wales, Australia for 752,374 women giving birth, 1994-2002. Analyses include a description of trends and regression analysis of risk factors for postpartum hemorrhage and comparison of predicted and observed rates of postpartum hemorrhage over time.

Results: Increasing proportions of women aged 35 years or older, born overseas, nulliparous, having cesarean births, having inductions and/or epidurals, postterm deliveries and large babies were evident. Observed postpartum hemorrhage rates increased from 4.7 to 6.0 per 100 births (P<0.001) while expected rates, adjusted for covariates, remained steady (P=0.28).

Conclusion: Increases in postpartum hemorrhage are not explained by the changing risk profile of women. It may be that changes in management and/or reporting of postpartum hemorrhage have resulted in higher postpartum hemorrhage rates.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Birth Weight
  • Cesarean Section / statistics & numerical data
  • Female
  • Humans
  • Infant, Newborn
  • New South Wales / epidemiology
  • Parity
  • Postpartum Hemorrhage / epidemiology*
  • Pregnancy