Predicting peripartum blood transfusion: focusing on pre-pregnancy characteristics

Abstract Backgroud Obstetric hemorrhage is one of the most common causes of obstetrical morbidity and mortality, and transfusion is the most important management for hemorrhage. The aim of our study was to investigate the pre-pregnancy and pregnancy risk factors for peripartum transfusion. Methods Women who delivered a baby from 2010 to 2014 and participated in the National Health Screening Program for Infants and Children were included. To analyze pre-pregnant risk factors for peripartum transfusion, an additional analysis was done for women who underwent a National Health Screening Examination within one year before pregnancy, including maternal waist circumference, body mass index, blood pressure, laboratory tests and history of smoking. Results Of the total 1,980,126 women who met the inclusion criteria, 36,868 (1.86%) were transfused at peripartum. In a multivariable regression model, the pregnancy risk factors for peripartum transfusion included maternal age above 35 years [odds ratio (OR): 1.41; 95% confidence interval (CI): 1.32–1.50], preterm birth (OR: 2.39; 95% CI: 2.15–2.65), and maternal hypertension (OR: 2.49; 95% CI: 2.24–2.77). Pre-pregnancy risk factors including fasting glucose level of more than 126 mg/dL (OR: 1.11; 95% CI: 1.02–1.20), current-smoker status (OR: 1.20; 95% CI: 1.06–1.37), and waist-circumference less than 80 cm (OR: 1.18; 95% CI: 1.06–1.30) were independently associated with peripartum blood transfusion. Conclusions Several pre-pregnancy and pregnancy risk factors were associated with peripartum blood transfusion. Some identified factors are modifiable before conception, and our study validated peripartum blood transfusion as a form of triage.

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Predicting peripartum blood transfusion: focusing on pre-pregnancy characteristics

10.21203/rs.2.13385/v2 ◽

2019 ◽

Author(s):

Yung-Taek Ouh ◽

Kyu-Min Lee ◽

Ki Hoon Ahn ◽

Soon-Cheol Hong ◽

Min-Jeong Oh ◽

...

Keyword(s):

Risk Factors ◽

Waist Circumference ◽

Blood Transfusion ◽

National Health ◽

Screening Program ◽

Health Screening ◽

Current Smoker ◽

Pregnancy Risk ◽

Maternal Hypertension ◽

One Year

Abstract Backgroud Obstetric hemorrhage is one of the most common causes of obstetrical morbidity and mortality, and transfusion is the most important management for hemorrhage. The aim of our study was to investigate the pre-pregnancy and pregnancy risk factors for peripartum transfusion. Methods Women who delivered a baby from 2010 to 2014 and participated in the National Health Screening Program for Infants and Children were included. To analyze pre-pregnant risk factors for peripartum transfusion, an additional analysis was done for women who underwent a National Health Screening Examination within one year before pregnancy, including maternal waist circumference, body mass index, blood pressure, laboratory tests and history of smoking. Results Of the total 1,980,126 women who met the inclusion criteria, 36,868 (1.86%) were transfused at peripartum. In a multivariable regression model, the pregnancy risk factors for peripartum transfusion included maternal age above 35 years [odds ratio (OR): 1.41; 95% confidence interval (CI): 1.32–1.50], preterm birth (OR: 2.39; 95% CI: 2.15–2.65), and maternal hypertension (OR: 2.49; 95% CI: 2.24–2.77). Pre-pregnancy risk factors including fasting glucose level of more than 126 mg/dL (OR: 1.11; 95% CI: 1.02–1.20), current-smoker status (OR: 1.20; 95% CI: 1.06–1.37), and waist-circumference less than 80 cm (OR: 1.18; 95% CI: 1.06–1.30) were independently associated with peripartum blood transfusion. Conclusions Several pre-pregnancy and pregnancy risk factors were associated with peripartum blood transfusion. Some identified factors are modifiable before conception, and our study validated peripartum blood transfusion as a form of triage.

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Predicting peripartum blood transfusion: focusing on pre-pregnancy characteristics

10.21203/rs.2.13385/v4 ◽

2019 ◽

Author(s):

Yung-Taek Ouh ◽

Kyu-Min Lee ◽

Ki Hoon Ahn ◽

Soon-Cheol Hong ◽

Min-Jeong Oh ◽

...

Keyword(s):

Risk Factors ◽

Waist Circumference ◽

Blood Transfusion ◽

National Health ◽

Screening Program ◽

Health Screening ◽

Current Smoker ◽

Multivariable Logistic Regression Analysis ◽

Pregnancy Risk ◽

Maternal Hypertension

Abstract Background: Obstetric hemorrhage is one of the most common causes of obstetrical morbidity and mortality, and transfusion is the most important management for hemorrhage. The aim of our study was to investigate the pre-pregnancy and pregnancy risk factors for peripartum transfusion. Methods: Women who delivered a baby from 2010 to 2014 and participated in the National Health Screening Program for Infants and Children were included. To analyze pre-pregnant risk factors for peripartum transfusion, an additional analysis was done for women who underwent a National Health Screening Examination within one year before pregnancy, including maternal waist circumference, body mass index, blood pressure, laboratory tests and history of smoking. Multivariable logistic regression analysis was used to estimate the risk factors for peripartum transfusion. Results: Of the total 1,980,126 women who met the inclusion criteria, 36,868 (1.86%) were transfused at peripartum. In a multivariable regression model, the pregnancy risk factors for peripartum transfusion included maternal age above 35 years [odds ratio (OR): 1.41; 95% confidence interval (CI): 1.32–1.50], preterm birth (OR: 2.39; 95% CI: 2.15–2.65), and maternal hypertension (OR: 2.49; 95% CI: 2.24–2.77). Pre-pregnancy risk factors including fasting glucose level of more than 126 mg/dL (OR: 1.11; 95% CI: 1.02–1.20), current-smoker status (OR: 1.20; 95% CI: 1.06–1.37), and waist-circumference less than 80 cm (OR: 1.18; 95% CI: 1.06–1.30) were independently associated with peripartum blood transfusion. Conclusions: Several pre-pregnancy and pregnancy risk factors were associated with peripartum blood transfusion. Some identified factors are modifiable before conception, and our study validated peripartum blood transfusion as a form of triage. Keywords: Peripartum, Blood transfusion, Postpartum hemorrhage

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Predicting peripartum blood transfusion: focusing on pre-pregnancy characteristics

10.21203/rs.2.13385/v5 ◽

2019 ◽

Author(s):

Yung-Taek Ouh ◽

Kyu-Min Lee ◽

Ki Hoon Ahn ◽

Soon-Cheol Hong ◽

Min-Jeong Oh ◽

...

Keyword(s):

Risk Factors ◽

Waist Circumference ◽

Blood Transfusion ◽

National Health ◽

Screening Program ◽

Health Screening ◽

Current Smoker ◽

Multivariable Logistic Regression Analysis ◽

Pregnancy Risk ◽

Maternal Hypertension

Abstract Background: Obstetric hemorrhage is one of the most common causes of obstetrical morbidity and mortality, and transfusion is the most important management for hemorrhage. The aim of our study was to investigate the pre-pregnancy and pregnancy risk factors for peripartum transfusion. Methods: Women who delivered a baby from 2010 to 2014 in Korea and participated in the Korean National Health Screening Program for Infants and Children were included. To analyze pre-pregnant risk factors for peripartum transfusion, an additional analysis was done for women who underwent a National Health Screening Examination within one year before pregnancy, including maternal waist circumference, body mass index, blood pressure, laboratory tests and history of smoking. Multivariable logistic regression analysis was used to estimate the risk factors for peripartum transfusion. Results: Of the total 1,980,126 women who met the inclusion criteria, 36,868 (1.86%) were transfused at peripartum. In a multivariable regression model, the pregnancy risk factors for peripartum transfusion included maternal age above 35 years [odds ratio (OR): 1.41; 95% confidence interval (CI): 1.32–1.50], preterm birth (OR: 2.39; 95% CI: 2.15–2.65), and maternal hypertension (OR: 2.49; 95% CI: 2.24–2.77). Pre-pregnancy risk factors including fasting glucose level of more than 126 mg/dL (OR: 1.11; 95% CI: 1.02–1.20), current-smoker status (OR: 1.20; 95% CI: 1.06–1.37), and waist-circumference less than 80 cm (OR: 1.18; 95% CI: 1.06–1.30) were independently associated with peripartum blood transfusion. Conclusions: Several pre-pregnancy and pregnancy risk factors were associated with peripartum blood transfusion. Some identified factors are modifiable before conception, and our study validated peripartum blood transfusion as a form of triage. Keywords: Peripartum, Blood transfusion, Postpartum hemorrhage

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Predicting peripartum blood transfusion: focusing on pre-pregnancy characteristics

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2646-3 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Yung-Taek Ouh ◽

Kyu-Min Lee ◽

Ki Hoon Ahn ◽

Soon-Cheol Hong ◽

Min-Jeong Oh ◽

...

Keyword(s):

Risk Factors ◽

Waist Circumference ◽

Blood Transfusion ◽

National Health ◽

Screening Program ◽

Health Screening ◽

Current Smoker ◽

Multivariable Logistic Regression Analysis ◽

Pregnancy Risk ◽

Maternal Hypertension

Abstract Background Obstetric hemorrhage is one of the most common causes of obstetrical morbidity and mortality, and transfusion is the most important management for hemorrhage. The aim of our study was to investigate the pre-pregnancy and pregnancy risk factors for peripartum transfusion. Methods Women who delivered a baby from 2010 to 2014 in Korea and participated in the Korean National Health Screening Program for Infants and Children were included. To analyze pre-pregnant risk factors for peripartum transfusion, an additional analysis was done for women who underwent a National Health Screening Examination within 1 year before pregnancy, including maternal waist circumference, body mass index, blood pressure, laboratory tests and history of smoking. Multivariable logistic regression analysis was used to estimate the risk factors for peripartum transfusion. Results Of the total 1,980,126 women who met the inclusion criteria, 36,868 (1.86%) were transfused at peripartum. In a multivariable regression model, the pregnancy risk factors for peripartum transfusion included maternal age above 35 years [odds ratio (OR): 1.41; 95% confidence interval (CI): 1.32–1.50], preterm birth (OR: 2.39; 95% CI: 2.15–2.65), and maternal hypertension (OR: 2.49; 95% CI: 2.24–2.77). Pre-pregnancy risk factors including fasting glucose level of more than 126 mg/dL (OR: 1.11; 95% CI: 1.02–1.20), current-smoker status (OR: 1.20; 95% CI: 1.06–1.37), and waist-circumference less than 80 cm (OR: 1.18; 95% CI: 1.06–1.30) were independently associated with peripartum blood transfusion. Conclusions Several pre-pregnancy and pregnancy risk factors were associated with peripartum blood transfusion. Some identified factors are modifiable before conception, and our study validated peripartum blood transfusion as a form of triage.

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One-year evaluation of the national health screening program for infants and children in Korea

Korean Journal of Pediatrics ◽

10.3345/kjp.2010.53.3.307 ◽

2010 ◽

Vol 53 (3) ◽

pp. 307 ◽

Cited By ~ 11

Author(s):

Jin Soo Moon ◽

Soon Young Lee ◽

Baik-Lin Eun ◽

Seong Woo Kim ◽

Young Key Kim ◽

...

Keyword(s):

National Health ◽

Screening Program ◽

Health Screening ◽

Infants And Children ◽

One Year ◽

Health Screening Program

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Prediction of cardiovascular disease in Korean population: based on health risk appraisal of national health screening program

Journal of Korean Medical Association ◽

10.5124/jkma.2017.60.9.746 ◽

2017 ◽

Vol 60 (9) ◽

pp. 746 ◽

Cited By ~ 1

Author(s):

Jae Moon Yun ◽

Tae Gon Yoo ◽

Seung-Won Oh ◽

Be Long Cho ◽

Eunyoung Kim ◽

...

Keyword(s):

Cardiovascular Disease ◽

Health Risk ◽

National Health ◽

Screening Program ◽

Population Based ◽

Health Screening ◽

Korean Population ◽

Risk Appraisal ◽

Health Risk Appraisal ◽

Health Screening Program

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Low presription of ACEI/ARB among hypertensive patients who showed two consecutive albuminuria during national health screening program in Korea

Journal of the American Society of Hypertension ◽

10.1016/j.jash.2014.03.234 ◽

2014 ◽

Vol 8 (4) ◽

pp. e102

Author(s):

Eunmi Ahn ◽

Dong Wook Shin ◽

Hyung-kook Yang ◽

Jae Moon Yun ◽

Hyejin Lee ◽

...

Keyword(s):

National Health ◽

Screening Program ◽

Health Screening ◽

Hypertensive Patients ◽

Health Screening Program

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Routine preoperative group and save for TURP and TURBT – need and cost effectiveness

Journal of Clinical Urology ◽

10.1177/2051415817717908 ◽

2017 ◽

Vol 11 (1) ◽

pp. 33-37

Author(s):

Hazel Smith ◽

Rachel Falconer ◽

Justyna Szczachor ◽

Sarfraz Ahmad

Keyword(s):

Risk Factors ◽

Cost Effectiveness ◽

Blood Transfusion ◽

Transurethral Resection ◽

Bladder Tumour ◽

Transurethral Resection Of Prostate ◽

Junior Doctors ◽

Two Samples ◽

Muscle Invasive ◽

One Year

Introduction: Standard practice in our unit is to take a group and save (G+S) blood sample for all patients undergoing a transurethral resection of prostate (TURP) and transurethral resection of bladder tumour (TURBT). Modern studies show the transfusion rates for TURP are 2%–7% and for TURBT 2%. Aims: We will determine how many patients undergoing TURP and TURBT required blood transfusion, analyse the indication, timing and risk factors. Additionally we will assess the cost effectiveness of routine G+S. Methods: A retrospective analysis was conducted between 1 March 2015 and 29 February 2016 (one year). Patients were identified from OPERA database and cross-referenced with blood transfusion records. Electronic case notes for patients receiving transfusions were reviewed. Results: A total of 167 patients underwent TURP. Of these, 0.6% (1/167) received transfusion on day 4 post-op. A total of 160 patients underwent TURBT. Overall 3.8% (6/160) received transfusion: three patients on days 0–1 and three patients on days 2–30. All patients had pre-op Hb <100 g/l. All had large muscle-invasive tumours. Cost in our lab of a G+S sample is £23.52. Two samples are now required before blood can be issued. Discussion: Our study shows that risk factors for transfusion are large prostates, likely muscle-invasive bladder tumours and pre-op Hb <100 g/l. Other risks include coagulopathy. These will usually be identified by the surgeon or pre-assessment clinic prior to the procedure. Change in policy would save money and time of phlebotomists and junior doctors. Conclusions: Routine G+S is not necessary for all patients. Patients with risk factors can be identified preoperatively. This would give a potential saving of over £15,000 per year. This can be implemented without adversely affecting patient safety.

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