Increasing BMI Ups Atonic Uterus Hemorrhage Risk

But no association between obesity and risk of postpartum hemorrhage with retained placenta

TUESDAY, Aug. 30 (HealthDay News) -- The risk of postpartum atonic uterus hemorrhage increases with increasing maternal body mass index (BMI), but there is no correlation between obesity and postpartum hemorrhage with retained placenta, according to a study published in the September issue of Obstetrics & Gynecology.

Marie Blomberg, M.D., Ph.D., from Linköping University in Sweden, investigated whether maternal obesity is associated with an increased risk for postpartum hemorrhage of more than 1,000 mL, and its association with causes of postpartum hemorrhage and mode of delivery in 1,114,071 Swedish women with singleton pregnancies who gave birth from 1997 through 2008. The participants were grouped into six BMI classes. Risk of postpartum hemorrhage was compared between obese women (class I-III) and those with normal weights, after adjustments. Receiving heparin-like drugs over BMI strata was evaluated in a subgroup.

The investigator found that increased prevalence of postpartum hemorrhage was correlated with changes in maternal characteristics. The risk for atonic uterine hemorrhage increased with increasing BMI, two-fold in women from obesity class III (1.8 percent). Maternal obesity was not found to be associated with postpartum hemorrhage due to retained placenta. Compared to normal-weight women (4.4 percent), those with a BMI of 40 or higher (5.2 percent) had an increased risk of postpartum hemorrhage after normal delivery (odds ratio [OR], 1.23). This was augmented further after an instrumental delivery (OR, 1.69), compared to normal-weight women (13.6 versus 8.8 percent, respectively). Maternal obesity was identified as a risk factor for receiving heparin-like drugs (OR, 2.86).

"The risk of postpartum hemorrhage attributable to atonic uterus markedly increased with increasing maternal BMI," the author writes.

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