Development of antepartum risk prediction model for postpartum hemorrhage in Lagos, Nigeria: A prospective cohort study (Predict-PPH study).

Autor: Okunade KS; Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Surulere, Lagos, Nigeria.; Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria.; Center for Clinical Trials, Research and Implementation Science, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria., Ugwu AO; Department of Obstetrics and Gynaecology, Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria., Adenekan MA; Department of Obstetrics and Gynaecology, Lagos Island Maternity Hospital, Lagos Island, Lagos, Nigeria., Olumodeji A; Department of Obstetrics and Gynaecology, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria., Oshodi YA; Department of Obstetrics and Gynaecology, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria., Ojo T; Department of Obstetrics and Gynaecology, Federal Medical Center, Ebute-Meta, Lagos, Nigeria., Adejimi AA; Department of Community Health and Primary Care, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria., Ademuyiwa IY; Department of Nursing Science, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria., Adaramoye V; Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Surulere, Lagos, Nigeria., Okoro AC; Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Surulere, Lagos, Nigeria., Olowe A; Department of Nursing Science, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria., Akinmola OO; Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria., John-Olabode SO; Department of Chemical Pathology, Lagos University Teaching Hospital, Surulere, Lagos, Nigeria., Adelabu H; Center for Clinical Trials, Research and Implementation Science, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria., Henriquez R; Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium., Decroo T; Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium., Lynen L; Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2024 Jul; Vol. 166 (1), pp. 343-352. Date of Electronic Publication: 2024 Jan 17.
DOI: 10.1002/ijgo.15364
Abstrakt: Objectives: There is currently a limited ability to accurately identify women at risk of postpartum hemorrhage (PPH). We conducted the "Predict-PPH" study to develop and evaluate an antepartum prediction model and its derived risk-scoring system.
Methods: This was a prospective cohort study of healthy pregnant women who registered and gave birth in five hospitals in Lagos, Nigeria, from January to June 2023. Maternal antepartum characteristics were compared between women with and without PPH. A predictive multivariable model was estimated using binary logistic regression with a backward stepwise approach eliminating variables when P was greater than 0.10. Statistically significant associations in the final model were reported when P was less than 0.05.
Results: The prevalence of PPH in the enrolled cohort was 37.1%. Independent predictors of PPH such as maternal obesity (adjusted odds ratio [aOR] 3.25, 95% confidence interval [CI] 2.47-4.26), maternal anemia (aOR 1.32, 95% CI 1.02-1.72), previous history of cesarean delivery (aOR 4.24, 95% CI 3.13-5.73), and previous PPH (aOR 2.65, 95% CI 1.07-6.56) were incorporated to develop a risk-scoring system. The area under the receiver operating characteristic curve (AUROC) for the prediction model and risk scoring system was 0.72 (95% CI 0.69-0.75).
Conclusion: We recorded a relatively high prevalence of PPH. Our model performance was satisfactory in identifying women at risk of PPH. Therefore, the derived risk-scoring system could be a useful tool to screen and identify pregnant women at risk of PPH during their routine antenatal assessment for birth preparedness and complication readiness.
(© 2024 International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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