Incidence and trend of severe postpartum hemorrhage between 2016 and 2019 in China
10.3760/cma.j.cn112141-20210209-00070
- VernacularTitle:2016—2019年中国严重产后出血的流行病学现状和变化趋势
- Author:
Huifeng SHI
1
;
Lian CHEN
;
Xiaoxia WANG
;
Hai JIANG
;
Shu DONG
;
Yu ZHUANG
;
Yuan WEI
;
Jie QIAO
;
Xudong MA
;
Yangyu ZHAO
Author Information
1. 北京大学第三医院妇产科 国家妇产疾病临床医学研究中心 国家产科专业医疗质量控制中心 100191
- Keywords:
Postpartum hemorrhage;
Incidence;
Epidemiologic studies;
China
- From:
Chinese Journal of Obstetrics and Gynecology
2021;56(7):451-457
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the incidence and trend of severe postpartum hemorrhage (sPPH) in China, and to provide basic data for the development and evaluation of sPPH prevention and control strategy.Methods:Obstetric data was extracted from annual national representative sampling surveys based on the National Clinical Improvement System. From 2016 to 2019, 2 978, 3 400, 4 576 and 4 594 maternity hospitals with sPPH cases were included for statistics. The annual incidence of sPPH was calculated according to province and type of medical institutions and generalized linear model was emplyed to identify the determinants affecting sPPH incidence.Results:In China, sPPH incidence increased from 0.62% in 2016 to 0.93% in 2018, and was 0.92% in 2019. Eighteen provinces had an inverted U-shaped trend of sPPH over time and most of them had the highest incidence in 2018; ten provinces had an upward trend of sPPH and 3 provinces had a U-shaped trend. In 2019, the top five provinces with the highest sPPH incidence were Yunnan (1.88%), Beijing (1.45%), Jiangsu (1.31%), Guizhou (1.26%), and Ningxia Hui Autonomous Region (1.22%); the top five provinces with the lowest incidence were Henan (0.55%), Jiangxi (0.60%), Inner Mongolia Autonomous Region (0.64%), Liaoning (0.64%) and Gansu (0.69%). In 2019, the sPPH incidence in different types of medical institutions were as follows: tertiary public general hospital (1.15%), tertiary public specialized hospital (1.02%), secondary public general hospital (0.81%), private hospital (0.61%) and secondary public specialized hospital (0.58%). sPPH incidence was positively associated with proportion of twin pregnancies, macrosomia, primipara, and puerpera aged ≥35 years in maternity hospitals ( P<0.05). Conclusions:sPPH incidence generally showes an increasing trend from 2016 and is stable at a high level in recent two years in China. It is warranted to further strengthen the monitoring of postpartum hemorrhage, and improve the capability of hierarchical management and treatment in maternity institutions and regions, in order to reduce sPPH incidence and maternal mortality.
