Emotional and physical health outcomes after significant primary post-partum haemorrhage (PPH): A multicentre cohort study

Background: Post‐partum haemorrhage (PPH) rates are rising; however, data on the health impact on women are lacking. Aims: To describe the emotional and physical health outcomes for women following PPH. Methods: A cohort of 206 women with primary PPH of 1500 mL or more, and/or peripartum fall in haemoglobin concentration to 7 g/dL or less, and/or of 4 g/dL or less, was recruited from 17 Australian/New Zealand hospitals. Women completed questionnaires in the first week, and at two and four months post‐partum. Obstetric details came from hospital records. Outcomes were anxiety; post‐natal depression (PND); fatigue; post‐traumatic stress disorder (PTSD); general health (SF‐36); physical health problems; post‐natal bleeding duration; hospital readmission. Results: Eighty‐three percent completed the two‐month and 81% the four‐month questionnaires; 28% reported bleeding continuously for more than six weeks; 10% required hospital readmission within two months. Anxiety scores were in the medium range; 11 and 13% were at risk of PND at two and four months, respectively; median total fatigue scores were 17 at two and 15 at four months; 5% showed evidence of PTSD at two and 3% at four months; women scored highly in most SF‐36 categories and showed improvements over time in all but general and mental health. Physical health concerns were comparable to those reported for general post‐natal populations, with the exception of uterine infection (6% at two months). Conclusions: In a cohort of women experiencing PPH, emotional and physical health outcomes were similar to those reported in general post‐natal populations, with the exception of post‐natal bleeding duration, uterine infection and hospital readmission.