An Association between Postpartum Hemorrhage and Risk of Cardiovascular Disease in Later Life

Evidence suggests that postpartum hemorrhage (PPH) is linked to acute physical consequences such sepsis, hypovolaemic shock, and disseminated intravascular coagulation. According to a recent systematic study, PPH may have long-term detrimental effects on women, including cardiovascular disease (CVD). The current population-based retrospective cohort study also examined the association between postpartum haemorrhage (PPH) and subsequent cardiovascular disease.

The study analyzed a cohort of 70,904 women who gave birth after 24 weeks of gestation between 1986 and 2016. Researchers employed extended Cox regression models to explore the relationship between experiencing one or more episodes of PPH during any birth and the risk of developing subsequent cardiovascular disease.

The study revealed the following findings:

• In a cohort of 70,904 women with 124,795 birth records, 25,177 women (36%) experienced at least one episode of PPH. 
• Compared to women without PPH, those with at least one occurrence had a significantly higher risk of developing cardiovascular disease in the first year after birth, with an adjusted hazard ratio (aHR) of 1.96 (95% CI 1.51–2.53). 
• Although the association diminished over time, a notable increased risk persisted at 2–5 years post-delivery (aHR 1.19, 95% CI 1.11–1.30) and at 6–15 years (aHR 1.17, 95% CI 1.05–1.30).

To conclude, women who have experienced at least one episode of PPH are twice as likely to develop cardiovascular disease within the first year after childbirth compared to those who have never had PPH. Additionally, some increased risk remains evident for up to 15 years post-delivery.

Source: Latt SM, Opondo C, Alderdice F, Kurinczuk JJ, Rowe R. Postpartum haemorrhage and risk of cardiovascular disease in later life: A population-based record linkage cohort study. An International Journal of Obstetrics and Gynaecology. July 2024. https://doi.org/10.1111/1471-0528.17896