Postpartum hemorrhage following vaginal delivery and associated risk factors in the United Arab Emirates: The Mutaba'ah study.

BACKGROUND

Postpartum hemorrhage (PPH) is a global health concern and remains the leading cause of maternal death worldwide. Studies assessing the prevalence of PPH and related maternal risk factors in the United Arab Emirates are scarce.

OBJECTIVES

This study aims to evaluate the prevalence of PPH and associated maternal risk factors in women in the Emirate of Abu Dhabi.

DESIGN

Prospective mother and child cohort study.

METHODS

This analysis was based on data from the Mutaba'ah Study. The sample composed of 2937 women who underwent normal vaginal delivery (2017-2023). Descriptive analysis was performed to compare the characteristics between patients with PPH and those without PPH. Logistic regression analysis was performed to identify maternal characteristics associated with PPH.

RESULTS

Overall prevalence of PPH was 4.3% (n = 125, 95% CI: 3.6%-5.1%). The median total blood loss among women with PPH was 700 mL (interquartile range (IQR): 600-1000), and 20% of affected women required blood transfusion. No observed significant difference between those with and without PPH regarding maternal education, body mass index, and comorbidities (p > 0.05). Women with PPH were younger at pregnancy (median (IQR): 28.4 (23.8, 34.3) versus 29.8 (25.4, 34.6), p = 0.022), and had higher proportions of assisted vaginal delivery (13% versus 3.7%, p < 0.001) compared to those without PPH. Women with PPH had significantly greater neonate weight compared to women without PPH (median (IQR): 3210 (2975, 3490) versus 3140 (2865, 3430), p = 0.029). In the adjusted analysis, women who underwent assisted vaginal delivery (adjusted odds ratio, aOR (95% CI): 2.82 (1.60, 4.97)), and those with increased neonate weight (aOR per 100 g: 1.06 (1.01, 1.10)) remained significantly associated with developing PPH.

CONCLUSION

Findings of this study underscore the importance of early identification of women at increased risk of PPH to provide tailored obstetric care. Improved management protocols and increased awareness among healthcare providers are essential to mitigate the risk of PPH and ultimately enhance maternal outcomes.