325The incidence of primary postpartum haemorrhage following in-hospital birth: a systematic review and meta-analysis

Background Although primary postpartum haemorrhage is a leading cause of maternal mortality, in the wider literature, there is inconsistent results in studies about its incidence. This study was designed to determine the pooled incidence of primary postpartum haemorrhage among women following in-hospital births. Methods This review used a systematic review and meta-analysis approach. We systematically searched electronic databases of Ovid MEDLINE, Ovid Emcare, Embase, PsycINFO, and CINAHL. Studies reporting the incidence of primary postpartum haemorrhage following in-hospital births were included. The pooled incidence of primary postpartum haemorrhage with a 95% confidence interval was calculated using random-effects model. Heterogeneity test between studies, and publication bias were assessed with I-square statistics and Egger’s test respectively. Results Ten of the 1548 studies were found to be eligible and were included in this systematic review and meta-analysis. The pooled incidence of primary postpartum haemorrhage following in-hospital births was nearly 12% (95% CI: 7.74- 17.61), with no evidence of between studies heterogeneity. Conclusions The incidence of primary postpartum haemorrhage following in-hospital births was high, and suggest that preventive strategies implemented to reduce its occurrence needs further strengthening using training. Key messages The result of this review suggests that globally at least one in ten women experience a primary postpartum haemorrhage following in-hospital births. This is higher than anticipated. The application of the recommended strategies for the prevention of primary postpartum haemorrhage should be re-emphasized.