Risk factors for blood component therapy in parturients—Case–control study

Daniel Gabbai, Ariel Many, Liat Lerner-Geva, Emmanuel Attali

Research output: Contribution to journalArticlepeer-review


Objective: Postpartum hemorrhage is a major cause of maternal morbidity and mortality, so early identification of patients at risk is crucial. In this study, we aim to assess the risk factors for major transfusion in parturients. Methods: A case–control study was conducted between 2011 and 2019. The cases included women who were treated with postpartum major transfusion compared with two control groups, one of which was treated with 1–2 packed red blood cells and one of which was not treated with packed red blood cells. Cases were matched with controls based on two variables: multiple pregnancies and previous history of three or more cesarean sections. A multivariable conditional logistic regression model was used to determine the role of the independent risk factors. Results: Of the 187 424 deliveries included in the present study, 246 (0.3%) women were treated with major transfusions. After applying a multivariate analysis, maternal age (odds ratio [OR] 1.07, 95% confidence interval [CI] 0.996–1.16), antenatal anemia with hemoglobin less than 10 g/dL (OR 12.58, 95% CI 2.86–55.25), retained placenta (OR 5.5, 95% CI 2.15–13.78), and cesarean delivery (OR 10.12, 95% CI 0.93–1.95) remained independent risk factors for major transfusions. Discussion: Retained placenta and antenatal anemia (hemoglobin < 10 g/dL) are independent risk factors for major transfusion. Of these, anemia was found to be the most significant.

Original languageEnglish
Pages (from-to)906-912
Number of pages7
JournalInternational Journal of Gynecology and Obstetrics
Issue number3
StatePublished - Sep 2023


  • anemia
  • case–control
  • delivery
  • hemorrhage
  • obstetrics
  • packed cells

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynaecology


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