Postpartum hemorrhage and future pregnancies

Researchers in Scotland have found that although women whose first pregnancies are complicated by postpartum hemorrhage (PPH) do not have reduced fertility, they do have an increased risk of PPH in later pregnancies. Notably, they also found that women who have cesarean sections at the time of PPH are less likely to conceive again. The study was published January 23 in BJOG: An International Journal of Obstetrics and Gynaecology.

The researchers conducted a study on PPH at the Aberdeen Maternity Hospital in Scotland over a 20-year period (1986-2005), using information from the Aberdeen Maternity and Neonatal Databank. Using data from 34,334 first pregnancies, they found that 10% experienced PPH.

The paper identified increased maternal age, high body mass index, and smoking as risk factors for PPH.

For the study, the 34,334 women were monitored for a minimum of 5 years to identify second pregnancies. Women who had experienced PPH in their first pregnancies were then compared to women who had not.

Researchers found that there were no significant differences between those who experienced PPH and those who did not for the proportion of women who went on to conceive a second pregnancy, in the time interval between pregnancies, or in early/late pregnancy loss.

However, mode of delivery among women who had initially experienced PPH was a significant factor in the likelihood of a second pregnancy, according to the study. Of the women who initially had cesarean sections complicated by PPH, 41.5% did not go on to have second pregnancies, compared to 36.8% of women who had cesarean sections that were not complicated by PPH.

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