Embryo transfer is a risk factor for severe postpartum hemorrhage and blood transfusion requirement

Purpose: This study aimed to investigate the risk factors for severe postpartum hemorrhage (PPH) and blood transfusion requirement that are recognizable during any period of pregnancy. Materials and methods: We retrospectively reviewed the medical data of 4829 pregnant women who received care and delivered at our institution between July 2010 and March 2015. The cohort was divided into patients with and without severe PPH. Multivariate logistic regression analysis was performed to assess risk factors associated with severe PPH. The same analysis was repeated for blood transfusion requirement. Results: A total of 127 (2.7%) patients had severe PPH and 43 (0.87%) required blood transfusion. The multivariate logistic regression analysis demonstrated that embryo transfer (odds ratio [OR] 2.6; p < .001), uterine myoma (OR 2.0; p < .01), prior uterine surgery (OR 1.9; p = .03), prior cesarean section (OR 1.8; p = .01), and maternal age (OR 1.5; p = .03) were independent risk factors for severe PPH. Embryo transfer was an independent risk factor for blood transfusion requirement (OR 3.1, p < .001). Conclusions: Embryo transfer is a risk factor for both severe postpartum hemorrhage and blood transfusion requirement.