Effect of maternal age on blood loss during parturition: a retrospective multivariate analysis of 10,053 cases.
OBJECTIVE
An extensive study as to whether maternal age itself is a risk factor for blood loss during parturition.


METHODS
A total of 10,053 consecutive women who delivered a singleton infant were studied. The excess blood loss was defined separately for women with vaginal and cesarean deliveries as > or = 90th centile value for each delivery mode. The effects of 13 potential risk factors on blood loss were analyzed using multivariate analysis.


RESULTS
The 90th centile value of blood loss was 615 ml and 1,531 ml for women with vaginal and cesarean deliveries, respectively. A low lying placenta (odds ratio [OR], 4.4), previous cesarean (3.1), operative delivery (2.6), leiomyoma (1.9), primiparity (1.6), and maternal age > or = 35 years (1.5) were significant independent risk factors for excess blood loss in women with vaginal delivery. Placenta previa (6.3), leiomyoma (3.6), low lying placenta (3.3), and maternal age > or = 35 years (1.8) were significant independent risk factors for excess blood loss in women with cesarean sections.


CONCLUSIONS
A maternal age of > or = 35 years was an independent risk factor for excess blood loss irrespective of the mode of delivery, even after adjusting for age-related complications such as leiomyoma, placenta previa, and low lying placenta.
Ohkuchi
Akihide
A
Department of Obstetrics and Gynecology, Jichi Medical School, Tochigi, Japan. okuchi@jichi.ac.jp
Onagawa
Tamaho
T
Usui
Rie
R
Koike
Toshimitsu
T
Hiratsuka
Mitsuhiro
M
Izumi
Akio
A
Ohkusa
Takashi
T
Matsubara
Shigeki
S
Sato
Ikuo
I
Suzuki
Mitsuaki
M
Minakami
Hisanori
H
D000328:Adult; D000704:Analysis of Variance; D001803:Blood Transfusion; D002585:Cesarean Section; D017604:Cesarean Section, Repeat; D036861:Delivery, Obstetric; D005260:Female; D006406:Hematoma / Q000150:complications; D006801:Humans; D007889:Leiomyoma / Q000150:complications; D016015:Logistic Models; D008423:Maternal Age; D016017:Odds Ratio; D010298:Parity; D010920:Placenta / Q000002:abnormalities; D006473:Postpartum Hemorrhage / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications; D012189:Retrospective Studies; D012307:Risk Factors; D014594:Uterine Neoplasms / Q000150:complications; D014597:Uterine Rupture / Q000150:complications; D014599:Uterus / Q000002:abnormalities