Risk factors for blood transfusion in Cesarean section : A systematic review and meta-analysis

Copyright © 2021 Société française de transfusion sanguine (SFTS). Published by Elsevier Masson SAS. All rights reserved..

OBJECTIVE: The current study has been conducted to identify the risk factors associated with blood transfusion in women undergoing cesarean section (C-section). A detailed account of the risk factors associated withblood transfusion will ultimately prevent unnecessary crossmatching in hospitals , leading to the conservation of declining blood supplies and resources without subjugating the quality of care.

MATERIAL AND METHODS: We performed a rigorous literature search using electronic databases, including PubMed, Cochrane CENTRAL, and Embase, for studies evaluating the risk factors for blood transfusion in C-section published until March 31, 2021. The Newcastle-Ottawa Quality Assessment Scale was deployed to assess the methodologic quality of the included studies. Mean differences (MD) and odds ratios (OR) with 95% confidence intervals were calculated using Review Manager version 5.3.

RESULTS: The search yielded 1563 records, 22 of which were eligible for inclusion, representing 426,094 women (10,959 in the transfused group and 415,135 in the non-transfused group). Participants in the transfused group had lower mean preoperative hematocrit (MD=-3.71 [-4.46, -2.96]; p<0.00001; I2=88%). Placenta previa (OR=9.54 [7.23, 12.59]; p<0.00001; I2=88%), placental abruption (OR=6.77 [5.25, 8.73]; p<0.00001; I2=72%), emergency C-section (OR=1.92 [1.42, 2.60]; p<0.0001; I2=75%), general anesthesia (OR=8.43 [7.90, 9.00]; p<0.00001; I2=72%), multiple gestations (OR=1.60 [1.24, 2.06]; p=0.0003; I2=85%), preterm labor (OR=3.34 [2.75, 4.06]; p<0.00001; I2=85%), prolonged labor (OR=1.68 [1.44, 1.96]; p<0.00001; I2=78%), unbooked cases (OR=2.42 [1.22, 4.80]; p=0.01; I2=80%), hypertensive disorders of pregnancy (OR=1.81 [1.72, 1.90]; p<0.00001; I2=71%), and fibroids (OR=2.32 [1.55, 3.47]; p<0.0001; I2=72%) were significantly higher in the transfused group compared to the non-transfused group. Chronic hypertension (OR=0.67 [0.29, 1.55]; p=0.36; I2=90%), maternal age (MD=0.09 [-0.27, 0.45]; p=0.62; I2=50%), maternal body mass index (MD=-0.14 [-0.81, 0.53]; p=0.67, I2=86%), diabetes (OR=0.93 [0.75, 1.15]; p=0.51; I2=52%), and malpresentation (OR=0.65 [0.38, 1.11]; p=0.13; I2=64%) were not significantly associated with an increased risk of blood transfusion in C-section in the two groups.

CONCLUSION: Placenta previa, placental abruption, emergency C-section, booking status, multiple gestations, and preoperative hematocrit were the risk factors most significantly associated with blood transfusion, while a prior C-section did not increase the risk of transfusion.

Medienart:	E-Artikel

Erscheinungsjahr:	2022
Erschienen:	2022

Enthalten in:	Zur Gesamtaufnahme - volume:29
Enthalten in:	Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine - 29(2022), 1 vom: 20. Feb., Seite 3-10

Sprache:	Englisch

Beteiligte Personen:	Iqbal, Kinza [VerfasserIn] Iqbal, Ayman [VerfasserIn] Rathore, Sawai Singh [VerfasserIn] Ahmed, Jawad [VerfasserIn] Ali, Shajeea Arshad [VerfasserIn] Farid, Eisha [VerfasserIn] Hasanain, Muhammad [VerfasserIn] Azeem, Qiraat [VerfasserIn] Qadar, Laila Tul [VerfasserIn] Memon, Fouzia Rasool [VerfasserIn] Azim, Dua [VerfasserIn]

Links:	Volltext

Themen:	Blood transfusion Césarienne Cesarean section Crossmatch transfusion ratio Facteurs de risque Hémorragie post-partum Journal Article Meta-Analysis Postpartum hemorrhage Ratio de transfusion de compatibilité croisée Risk factors Systematic Review Transfusion sanguine

Anmerkungen:	Date Completed 26.01.2022 Date Revised 26.01.2022 published: Print-Electronic Citation Status MEDLINE

doi:	10.1016/j.tracli.2021.09.010

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	NLM331753502