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Risk factors for blood transfusion in singleton pregnancy deliveries in Taiwan
Author(s) -
Jou HeiJen,
Hung HsinWen,
Yan YuanHorng,
Wu ShiaoChi
Publication year - 2012
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2011.11.028
Subject(s) - medicine , obstetrics , blood transfusion , odds ratio , placenta previa , pregnancy , incidence (geometry) , vaginal delivery , population , confidence interval , logistic regression , anemia , singleton , gynecology , fetus , placenta , surgery , physics , environmental health , biology , optics , genetics
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.