(B-239) Incidence of post-partum hemorrhage and amount of blood loss in the Netherlands

Background: Postpartum hemorrhage (PPH) is a potentially life-threatening obstetric emergency. Understanding the real-world burden of PPH is critical to determine the added value of new treatments and devices. This is particularly important for quantifying the amount of blood loss, since availability of this information is limited.

Objectives: To assess the incidence of PPH in the Netherlands stratified by the amount of blood loss.

Methods: PPH cases between 2013 and 2022 were retrieved from the PHARMO Data Network, including hospital and in-patient pharmacy data, as well as data from the Netherlands Perinatal Registry (Perined). PPH was defined as: blood loss greater than or equal to 500 mL, or a PPH ICD-10 code within 12 weeks after delivery, or administration of uterotonics/parenteral tranexamic acid during hospital delivery. The amount of blood loss was available from the Perined data, both numerical (greater than or equal to 500 mL, according to the WHO definition) and binary based on a 1000 mL threshold (according to the Dutch definition).

Results: There were 52,876 births between 2013 and 2022 captured in Perined with additional linked hospital and in-patient pharmacy data available. Of these, 10,981 births (21%) were followed by PPH within 12 weeks after delivery, and the amount of blood loss was available for 9,251 PPH cases (84%). Based on this numerical blood loss variable alone, there were 5,441 PPH cases (59%) with 500-1000 mL blood loss, 3,010 PPH cases (32%) with >1000-1500 mL blood loss, and 800 PPH cases (9%) with >1500 mL blood loss between 2013 and 2022.

Conclusions: Using linked data from the PHARMO Data Network, 10,981 PPH cases were identified between 2013 and 2022 (21% of 52,876 births), with the amount of blood loss available for 84%. This cohort will be used to study the characteristics, treatment patterns, clinical outcomes, and healthcare resource utilization of women experiencing PPH.