{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T14:56:25Z","timestamp":1792248985770,"version":"4.4.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["P20GM103395"],"award-info":[{"award-number":["P20GM103395"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["P20GM152302"],"award-info":[{"award-number":["P20GM152302"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["S06GM142122"],"award-info":[{"award-number":["S06GM142122"]}],"id":[{"id":"10.13039\/100000057","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":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the relationship between prenatal vitamin D serum levels and postpartum bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective electronic health record cohort study of pregnant Alaska Native and American Indian (ANAI) people in southwestern Alaska who had at least one prenatal vitamin D level measurement recorded and had a vaginal birth between January 2017 and December 2019. Prenatal vitamin D level was the independent variable; postpartum abnormal bleeding and hemorrhage occurrence after a vaginal birth were the primary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1343 index pregnancies were included in this study, of which 1258 (94%) had a vaginal birth with 370 (29%) experiencing blood loss \u2265500\u2009mL and 127 (10%) \u22651000\u2009mL. Risk factors included prior postpartum hemorrhage, suspected macrosomia, twin gestation, magnesium sulfate use in the setting of pre\u2010eclampsia, induction time &gt;36\u2009h, oxytocin use &gt;12\u2009h and third stage of labor &gt;20\u2009min. Deficient vitamin D levels (under 12\u2009ng\/mL) were found in 10.5%, 4.8%, and 5.3% of records in the first, second and third trimesters, respectively. Logistic regression indicated an association between vitamin D level under 12\u2009ng\/mL in the first trimester and postpartum bleeding \u2265500\u2009mL (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009540,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0097, odds ratio [OR]\u2009=\u20092.2). No association was found between abnormal bleeding and being vitamin D deficient in the second and third trimesters.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is a need for further research of vitamin D screening and supplementation before and during pregnancy as a possible risk reduction tool for abnormal postpartum bleeding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70553","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T13:34:46Z","timestamp":1762436086000},"page":"403-410","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prenatal vitamin D levels and postpartum hemorrhage in a rural Alaska cohort"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1372-6068","authenticated-orcid":false,"given":"Reinou S.","family":"Groen","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Southcentral Foundation  Anchorage Alaska USA"},{"name":"Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4363-9763","authenticated-orcid":false,"given":"Julie A.","family":"Beans","sequence":"additional","affiliation":[{"name":"Southcentral Foundation, Research Department  Anchorage Alaska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen","family":"Day","sequence":"additional","affiliation":[{"name":"Alaska Native Tribal Health Consortium  Anchorage Alaska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauryl","family":"Torkelson","sequence":"additional","affiliation":[{"name":"Yukon Kuskokwim Health Corporation  Bethel Alaska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjali","family":"Madeira","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Southcentral Foundation  Anchorage Alaska USA"},{"name":"Southcentral Foundation, Research Department  Anchorage Alaska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Compton","sequence":"additional","affiliation":[{"name":"Yukon Kuskokwim Health Corporation  Bethel Alaska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Klejka","sequence":"additional","affiliation":[{"name":"Yukon Kuskokwim Health Corporation  Bethel Alaska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1824-6063","authenticated-orcid":false,"given":"Jennifer","family":"Shaw","sequence":"additional","affiliation":[{"name":"Southcentral Foundation, Research Department  Anchorage Alaska USA"},{"name":"Center for Alaska Native Health Research University of Alaska Fairbanks  Fairbanks Alaska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70227-X"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-9-55"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e3181cc406d"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000002351"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.02.023"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1105307"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2023.05.001"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13583"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2018.04.012"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.01.017"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000000869"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2020.8890"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.05.037"},{"key":"e_1_2_11_15_1","unstructured":"CDC.Postpartum Hemorrhage 1993\u20102014. 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