The incidence and risk factors of postpartum haemorrhage in a low resource setting
This was a retrospective study to investigate the incidence and identify risk factors of Postpartum Haemorrhage (PPH) in women attended to at Mpilo Central Hospital in Bulawayo, Zimbabwe during January 2017 – June 2018. Postpartum haemorrhage(PPH), as defined by the World Health Organisation (WHO), is vaginal blood loss in excess of 500ml following childbirth. Primary PPH is defined as blood loss of 500ml or more following a normal vaginal delivery (NVD) or 1,000ml or more following a Caesarean section, within 24 hours of birth. Logistic regression models were used to determine the association and interaction patterns among the variables, when identifying the risk factors, using the statistical software SPSS. Categorical data analysis will be carried out in SPSS, to develop a regression model for the likelihood to develop PPH. The predictor variables were age, gestational age, antenatal booking status, past obstetrics complications, parity, current complications and birth weight. Univariate analysis was done to determine the risk factors. Each independent variable was regressed against the dependent variable to test for significance for inclusion in the final model. The incidence rate was 1.66%, much less than is reported in literature for sub Saharan countries. The regression equation showed that for PPH (LSCS) relative to PPH (NVD), there was only one predictor (ENND1=0), with a regression coefficient significantly from zero so it was included in the final model. It shows that the relative log odds of being in PPH (LSCS) relative to PPH (NVD) would decrease by -3.969 if changing from (ENND1=1) to (ENND1 = 0).