Red blood cell transfusion after postpartum haemorrhage and breastmilk feeding at discharge: A population-based study.

Autor: Drayton BA; Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia.; Biostatistics Training Program, New South Wales Ministry of Health, North Sydney, New South Wales, Australia., Patterson JA; Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia.; Sydney Medical School Northern, University of Sydney, St Leonards, New South Wales, Australia., Nippita TA; Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia.; Sydney Medical School Northern, University of Sydney, St Leonards, New South Wales, Australia.; Department of Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards, New South Wales, Australia., Ford JB; Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia.; Sydney Medical School Northern, University of Sydney, St Leonards, New South Wales, Australia.
Jazyk: angličtina
Zdroj: The Australian & New Zealand journal of obstetrics & gynaecology [Aust N Z J Obstet Gynaecol] 2016 Dec; Vol. 56 (6), pp. 591-598. Date of Electronic Publication: 2016 Jun 15.
DOI: 10.1111/ajo.12485
Abstrakt: Background: Recently released patient blood management guidelines for maternity patients in Australia highlighted the lack of evidence on functional outcomes post-transfusion.
Aim: This study aimed to determine the association between red blood cell transfusion and breastmilk feeding at discharge.
Materials and Methods: Population-based cohort study of all births (n = 522 534) of at least 20 weeks gestation or 400 g birthweight in New South Wales, 2007-2012. Multivariable Poisson regression was used to analyse the association between red cell transfusion post-delivery and breastfeeding at discharge among women experiencing a postpartum haemorrhage (PPH).
Results: Overall, 461 395 of 522 534 maternities were breastmilk feeding at discharge, a rate of 88% (82% exclusive; 6% partial). Of 35 588 maternities with a PPH that did not receive a transfusion, 31 387 were breastmilk feeding at discharge (88%; 81% exclusive; 7% partial). There were 4561 maternities with a PPH that were transfused and 3737 were breastmilk feeding at discharge (82%; 70% exclusive; 12% partial). After adjusting for differences in clinical and demographic characteristics, women receiving transfusions are 0.91 (99%CI: 0.89-0.93) times as likely to exclusively breastmilk feed at discharge, compared to nontransfused women. The rate of any breastmilk feeding is 0.94 (99% CI: 0.92-0.95) times lower for transfused women, compared to nontransfused women.
Conclusions: Transfused women have reduced breastmilk feeding rates at discharge. Caution is warranted when advising women that transfusion promotes breastmilk feeding. Additional lactation support may be required for transfused women.
(© 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)
Databáze: MEDLINE
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