Skip to main content
Log in

The association between ABO blood group and obstetric hemorrhage

  • Published:
Journal of Thrombosis and Thrombolysis Aims and scope Submit manuscript

Abstract

Whether intra- and early post-partum hemorrhage is influenced by ABO blood groups remains unknown. Therefore, we compared women with O to non-O blood groups with regard to maternal post-partum hemorrhage and transfusion need. This retrospective study was conducted in a single tertiary center between 2005 and 2014. For the purpose of the study, parturients were categorized as O and non-O blood groups. Data included all deliveries but excluded patients with missing blood grouping or hemoglobin values, and/or stillbirth. Drop in hemoglobin was defined as hemoglobin concentration at admission for delivery minus lowest hemoglobin concentration post-delivery. Study outcomes were postpartum hemorrhage, hemoglobin drop >2–7 g/dL inclusive, and packed red blood cells transfusion. Statistics: descriptive, χ2 (p < 0.05 significant) and multivariable regression models [odds ratio (OR), 95 % confidence interval (CI), p value]. 125,768 deliveries were included. After multivariable analysis, women with O blood type relative to women with non-O blood type had significantly higher odds of postpartum hemorrhage (OR 1.14; 95 % CI 1.05–1.23, p < 0.001), higher odds of statistically significant hemoglobin decreases of >2, 3, or 4 g/dL (OR 1.07; 95 % CI 1.04–1.11, p < 0.001, OR 1.08; 95 % CI 1.03–1.14, p = 0.002, OR 1.14; 95 % CI 1.05–1.23, p = 0.001; respectively), and higher odds, albeit not statistically significant of 5, 6, or 7 g/dL decreases in hemoglobin (OR 1.13; 95 % CI 1.00–1.29, p = 0.055, OR 1.05; 95 % CI 0.84–1.32, p = 0.66, OR 1.15; 95 % CI 0.79–1.68, p = 0.46; respectively), but no difference in blood products transfusion (OR 1.03; 95 % CI 0.92–1.16, p = 0.58). In conclusion, women with blood type O may be at greater risk of obstetrical hemorrhage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. World Health Organization (2012) Recommendations for the prevention and treatment of postpartum haemorrhage. http://apps.who.int/iris/bitstream/10665/75411/1/9789241548502_eng.pdf. Accessed 17 Nov 2015

  2. Welsby IJ, Phillips-Bute B, Mathew JP, Newman MF, Becker R, Rao S et al (2014) ABO blood group influences transfusion and survival after cardiac surgery. J Thromb Thrombolysis 38:402–408

    Article  PubMed  Google Scholar 

  3. Horwich L, Evans DA, McConnell RB, Donohoe WT (1996) ABO blood groups in gastric bleeding. Gut 7:680–685

    Article  Google Scholar 

  4. Franchini M, Crestani S, Rossi C, Frattini F, Mengoli C, Giacomini I et al (2013) O blood group and the risk of major bleeding: a single-center survey. J Thromb Thrombolysis 35:65–66

    Article  PubMed  Google Scholar 

  5. Kuyvenhoven JP, Veenendaal RA, Vandenbroucke JP (1999) Peptic ulcer bleeding: interaction between non-steroidal anti-inflammatory drugs, Helicobacter pylori infection, and the ABO blood group system. Scand J Gastroenterol 34:1082–1086

    Article  CAS  PubMed  Google Scholar 

  6. Gill JC, Endres-Brooks J, Bauer PJ, Marks WJ Jr, Montgomery RR (1987) The effect of ABO blood group on the diagnosis of von Willebrand disease. Blood 69:1691–1695

    CAS  PubMed  Google Scholar 

  7. Clark P, Walker ID, Govan L, Wu O, Greer IA (2008) The GOAL study: a prospective examination of the impact of factor V Leiden and ABO(H) blood groups on haemorrhagic and thrombotic pregnancy outcomes. Br J Haematol 140:236–240

    PubMed  Google Scholar 

  8. Stafford I, Dildy GA, Clark SL, Belford MA (2008) Visually and calculated blood loss in vaginal and cesarean delivery. Am J Obstet Gynecol 199:519.e1–519.e7

    Article  Google Scholar 

  9. James AH, Paglia MJ, Gernsheimer T et al (2009) Blood component therapy in postpartum hemorrhage. Transfusion 49:2430–2433

    Article  PubMed  Google Scholar 

  10. Callaghan WM, Kuklina EV, Berg CJ (2010) Trends in postpartum hemorrhage: United States, 1994–2006. Am J Obstet Gynecol 202:353.e1–353.e6

    Article  Google Scholar 

  11. Helman S, Drukker L, Fruchtman H, Ioscovich A, Farkash R et al (2015) Revisit of risk factors for major obstetric hemorrhage: insights from a large medical center. Arch Gynecol Obstet 292:819–828

    Article  PubMed  Google Scholar 

  12. Hancock A, Weeks AD, Lavender DT (2015) Is accurate and reliable blood loss estimation the ‘crucial step’ in early detection of postpartum haemorrhage: an integrative review of the literature. BMC Pregnancy Childbirth 15:230

    Article  PubMed  PubMed Central  Google Scholar 

  13. Lain SJ, Roberts CL, Hadfield RM, Bell JC, Morris JM (2008) How accurate is the reporting of obstetric haemorrhage in hospital discharge data? A validation study. Aust N Z J Obstet Gynaecol 48:481–484

    Article  PubMed  Google Scholar 

  14. Dentali F, Sironi AP, Ageno W, Bonfanti C, Crestani S et al (2013) Relationship between ABO blood group and hemorrhage: a systematic literature review and meta-analysis. Semin Thromb Hemost 39:72–82

    Article  PubMed  Google Scholar 

  15. Wickström K, Edelstam G, Löwbeer CH, Hansson LO, Siegbahn A (2004) Reference intervals for plasma levels of fibronectin, von Willebrand factor, free protein S and antithrombin during third-trimester pregnancy. Scand J Clin Lab Invest 64:31–40

    Article  PubMed  Google Scholar 

  16. Drukker L, Hants Y, Farkash R, Ruchlemer R, Samueloff A, Grisaru-Granovsky S (2015) Iron deficiency anemia at admission for labor and delivery is associated with an increased risk for Cesarean section and adverse maternal and neonatal outcomes. Transfusion 55:2799–2806

    Article  CAS  PubMed  Google Scholar 

  17. Blomberg M (2013) Maternal obesity, mode of delivery, and neonatal outcome. Obstet Gynecol 122:50–55

    Article  Google Scholar 

  18. Horowitz KM, Ingardia CJ, Borgida AF (2013) Anemia in pregnancy. Clin Lab Med 33:281–291

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Naama Srebnik.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

Lior Drukker and Naama Srebnik have contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Drukker, L., Srebnik, N., Elstein, D. et al. The association between ABO blood group and obstetric hemorrhage. J Thromb Thrombolysis 42, 340–345 (2016). https://doi.org/10.1007/s11239-016-1360-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11239-016-1360-5

Keywords

Navigation