{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T22:16:46Z","timestamp":1794003406444,"version":"4.8.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012781","name":"MSD K.K.","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012781","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine whether the observed non\u2010inferiority of heat\u2010stable carbetocin (HSC), compared with oxytocin, was influenced by biologic (macrosomia, parity 3 or more, or history of postpartum hemorrhage [PPH]) and\/or pharmacologic (induction or augmentation) risk factors for PPH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The present study is a secondary analysis of the CHAMPION non\u2010inferiority randomized trial\u2014a two\u2010arm, double\u2010blind, active\u2010controlled study conducted at 23 hospitals in 10 countries, between July 2015 and January 2018. Women with singleton pregnancies, expected to deliver vaginally with cervical dilatation up to 6\u2009cm were eligible. Randomization was stratified by country, with 1:1 assignment. Women in the intervention and control groups received a single intramuscular injection of 100\u2009\u03bcg of HSC or 10\u2009IU of oxytocin, respectively. The drugs were administered immediately after birth, and the third stage of labor was managed according to the WHO guidelines. Blood was collected using a plastic drape. For this analysis, we defined a woman as being at risk if she had any one or more of the biologic or pharmacologic risk factor(s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The HSC and oxytocin arms contained 14\u2009770 and 14\u2009768 women, respectively. The risk ratios (RR) for PPH were 1.29 (95% confidence interval [CI] 1.08\u20131.53) or 1.73 (95% CI 1.51\u20131.98) for those with only biologic (macrosomia, parity 3 or more, and PPH in the previous pregnancy) or only pharmacologic (induced or augmented) risk factors, respectively, compared with those with neither risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Findings reinforce previous evidence that macrosomia, high parity, history of PPH, and induction\/augmentation are risk factors for PPH. We did not find a difference in effects between HSC and oxytocin for PPH among women who were neither induced nor augmented or among those who were induced or augmented.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14938","type":"journal-article","created":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T07:29:08Z","timestamp":1687764548000},"page":"124-130","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Heat stable carbetocin or oxytocin for prevention of postpartum hemorrhage among women at risk: A secondary analysis of the <scp>CHAMPION<\/scp> trial"],"prefix":"10.1002","volume":"164","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7839-4148","authenticated-orcid":false,"given":"Rakesh","family":"Ghosh","sequence":"first","affiliation":[{"name":"Institute for Global Health Sciences University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olorunfemi","family":"Owa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Mother and Child Hospital  Akure Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Santos","sequence":"additional","affiliation":[{"name":"Institute for Global Health Sciences University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Butrick","sequence":"additional","affiliation":[{"name":"Institute for Global Health Sciences University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilda","family":"Piaggio","sequence":"additional","affiliation":[{"name":"Statistika Consultoria  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Widmer","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health and Research World Health Organization  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Althabe","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health and Research World Health Organization  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahaida","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Nairobi  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pisake","family":"Lumbiganon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Khon Kaen University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geetanjali","family":"Katageri","sequence":"additional","affiliation":[{"name":"S Nijalingappa Medical College  Bagalkot Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilys","family":"Walker","sequence":"additional","affiliation":[{"name":"Institute for Global Health Sciences University of California  San Francisco California USA"},{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,26]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization and UNICEF. 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