Precis: Obstetric blood transfusions continue to increase, with most of these occurring in the birth admission in association with hemorrhage.Objectives: To identify trends in transfusion rates across pregnancy and the postnatal period, and identify risk factors for transfusion. 81% of these transfusions were associated with a diagnosis of hemorrhage. Women with bleeding/platelet disorders(vaginal RR= 7.8, CI 7.1-8.5, cesarean RR 8.7, CI 7.9-9.5) and placenta previa(vaginal RR=4.6, CI 3.7-5.8, cesarean 5.7, CI 5.2-6.2), were at highest risk of transfusion. Among vaginal births, increased risk was evident for forceps (RR=2.8, CI 2.6-3.0) or vacuum births (RR=1.9, CI 1.7-2.0) compared with non-operative births.
Methods
Conclusions:Rates of obstetric blood product transfusion have increased by 33% since 2001, with the majority of this associated with hemorrhage. Women with bleeding/platelet disorders and placenta previa are at increased risk of transfusion, and should be managed accordingly.