Is Obesity a Risk factor for Postpartum Hemorrhage?

Abstract

Background: The incidence of postpartum hemorrhage has been increasing in several developed countries over the past two decades with the rate rising by over one third. This rise with its associated maternal morbidity and mortality is not explained by corresponding change in risk factors such as rise in cesarean section rate and induction of labor. Objectives: To confirm whether maternal obesity is associated with an increased risk of postpartum hemorrhage. Method: A prospective case-control study of 150 pregnant women hospitalised with spontaneous labour (Dec. 2021-Sept. 2022). (65) suffered postpartum haemorrhage (case group) and (85) did not (control group). Both groups' ages were equalised. Multiple pregnancies, polyhydramnios, prolonged & induced labour, intrauterine mortality, early membrane rupture, chorioamnionitis, placenta previa & abruption, hypertension, diabetes & anaemia were avoided. Visual assessment of blood loss, weighing blood-soaked items, and patient hemodynamic condition are used to diagnose postpartum haemorrhage. Maternal weight height was used to calculate BMI. Results: Among case group; (55.4%) were young age (i.e. 18-35y) and were multiparous (63%) compared to (53%, 62.3 %) respectively in the control. The main cause of postpartum hemorrhage was uterine atony (80%). In the case group ;( 46%) were overweight, (35%) obese class I and (7.7%) obese class II with no significant difference from the control (48.2 %, 27%, 4.7%) respectively. Cesarean section rate was (26%) compared to (11.7%) in the control with significant difference. Conclusion: Obesity seem not to be associated significantly with increased risk of postpartum hemorrhage.