Gestational hypertension as a risk factor for increased postpartum hemorrhage volume in placenta previa: A retrospective study

This study aims to identify risk factors associated with postpartum hemorrhage (PPH) volume in pregnant women diagnosed with placenta previa. We retrospectively collected data on PPH volume in consecutive pregnant women at the First People's Hospital of Zunyi between March 24, 2020, and February 28, 2024. The outcome variable, PPH volume, was divided into 5 categories: <500 mL, 500 to 1000 mL, 1001 to 1500 mL, 1501 to 2000 mL, and > 2000 mL, according to the Chinese Medical Association (CMA) obstetric guideline (2023 edition). These data were documented within 24 hours of birth. We examined maternal characteristics and concurrent pregnancy conditions to identify the potential risk factors for PPH volume. Univariate and multivariate ordered logistic regression analyses were used to determine the association between these factors and PPH volume, with the analysis conducted using SPSS statistical software (version 26.0). In total, 246 pregnant women were included in this retrospective study. Univariate analysis revealed that gestational hypertension increased the risk of an elevated volume of PPH, with an odds ratio (OR) of 5.336 (95% confidence interval [CI]: 1.204-23.656). This significance persisted in the multivariate ordered logistic regression analysis (OR = 6.445, 95% CI: 1.414-29.371), suggesting that pregnant women diagnosed with gestational hypertension are approximately 6.445 times more likely to experience a higher level of PPH volume than those without this condition. The mode of delivery, particularly cesarean section, was initially associated with a lower volume of PPH (OR = 0.393, 95% CI: 0.226-0.685); however, this association was not statistically significant in the multivariate analysis. Gestational hypertension significantly contributes to an increased PPH volume in patients with placenta previa. Clinicians must diligently monitor and manage such patients to mitigate the risk of severe PPH and related complications. Further research is required to validate our findings.