{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:33:30Z","timestamp":1740126810971,"version":"3.37.3"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"03","funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"crossref","award":["K23HL141640"],"award-info":[{"award-number":["K23HL141640"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>\n            Objective\u2003The World Health Organization recommends tranexamic acid (TXA) in the management of postpartum hemorrhage (PPH). However, the role of TXA in PPH prevention and the optimal timing of TXA administration remain unknown. Our objective was to describe the timing of TXA administration, differences in timing of TXA administration by mode of delivery, and current trends in TXA administration in the United States.<\/jats:p><jats:p>\n            Study Design\u2003We conducted a descriptive study of trends in TXA administration using the Cerner Real-World Database. We identified 1,544,712 deliveries occurring at greater than 24 weeks' gestation from January 1, 2016, to February 21, 2023. Demographic data were collected including gestational age, mode of delivery, and comorbidities. The timing of TXA administration and differences in TXA timing by mode of delivery were also collected.<\/jats:p><jats:p>\n            Results\u2003In our cohort, 21,433 patients (1.39%) received TXA. The majority of patients who received TXA were between ages 25 and 34 years old (55.3%), White (60.7%), and delivered between 37 and 416\/7 weeks (81.4%). The TXA group had a higher prevalence of medical comorbidities including obesity (32.9 vs. 19.0%, p\u2009&lt;\u20090.00001), preeclampsia (19.6 vs. 6.81%, p\u2009&lt;\u20090.00001), and pregestational diabetes (3.27 vs. 1.36%, p\u2009&lt;\u20090.00001). Among women who received TXA, 15.4% received it within 3\u2009hours before delivery. Among patients who received TXA after delivery, 23.6% received TXA within 3\u2009hours after delivery, whereas 35.7% received TXA between 10 and 24\u2009hours after delivery. A total of 80.4% of patients who received TXA before delivery had a cesarean delivery.<\/jats:p><jats:p>\n            Conclusion\u2003While TXA is most commonly administered after delivery, many patients are receiving TXA prior to delivery in the United States without clear evidence to guide the timing of administration. A randomized trial is urgently needed to determine the safety and efficacy of TXA when administered prior to delivery.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2353-0832","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T23:18:22Z","timestamp":1719443902000},"page":"327-333","source":"Crossref","is-referenced-by-count":0,"title":["When Are Pregnant Patients Receiving Tranexamic Acid during Delivery Hospitalization in the United States?"],"prefix":"10.1055","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1452-6519","authenticated-orcid":false,"given":"Julia","family":"Whitley","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine and Ultrasound, Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seyedeh A.","family":"Miran","sequence":"additional","affiliation":[{"name":"Department of Clinical Research and Leadership, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Clinical Research and Leadership, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Saade","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Roberts","sequence":"additional","affiliation":[{"name":"Clinical Trials Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0341-1086","authenticated-orcid":false,"given":"Homa K.","family":"Ahmadzia","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia"},{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Inova Health System, Falls Church, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,7,18]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1097\/AOG.0000000000004361","article-title":"Maternal mortality in the United States: recent trends, current status, and future considerations","volume":"137","author":"K S Joseph","year":"2021","journal-title":"Obstet Gynecol"},{"issue":"5663","key":"ref2","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1136\/bmj.3.5663.137","article-title":"Fibrin degradation products in normal and abnormal pregnancy and parturition","volume":"3","author":"J Bonnar","year":"1969","journal-title":"BMJ"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1093\/bja\/aew021","article-title":"Postpartum haemorrhage related early increase in D-dimers is inhibited by tranexamic acid: haemostasis parameters of a randomized controlled open labelled trial","volume":"116","author":"A S Ducloy-Bouthors","year":"2016","journal-title":"Br J Anaesth"},{"issue":"05","key":"ref4","first-page":"e38736","article-title":"Postpartum hemorrhage and tranexamic acid: a literature review","volume":"15","author":"S Anaposala","year":"2023","journal-title":"Cureus"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1016\/S0140-6736(17)30638-4","article-title":"Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial","volume":"389","author":"WOMAN Trial Collaborators","year":"2017","journal-title":"Lancet"},{"volume-title":"Updated WHO Recommendation on Tranexamic Acid for the Treatment of Postpartum Haemorrhage","year":"2017","author":"World Health Organization (WHO)","key":"ref6"},{"issue":"08","key":"ref7","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1056\/NEJMoa1800942","article-title":"Tranexamic acid for the prevention of blood loss after vaginal delivery","volume":"379","author":"L Sentilhes","year":"2018","journal-title":"N Engl J Med"},{"issue":"17","key":"ref8","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1056\/NEJMoa2028788","article-title":"Tranexamic acid for the prevention of blood loss after cesarean delivery","volume":"384","author":"L Sentilhes","year":"2021","journal-title":"N Engl J Med"},{"issue":"15","key":"ref9","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1056\/NEJMoa2207419","article-title":"Tranexamic acid to prevent obstetrical hemorrhage after cesarean delivery","volume":"388","author":"L D Pacheco","year":"2023","journal-title":"N Engl J Med"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"e210884","DOI":"10.1001\/jamasurg.2021.0884","article-title":"Association of intravenous tranexamic acid with thromboembolic events and mortality: a systematic review, meta-analysis, and meta-regression","volume":"156","author":"I Taeuber","year":"2021","journal-title":"JAMA Surg"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1186\/s13054-021-03799-9","article-title":"Effect of tranexamic acid on thrombotic events and seizures in bleeding patients: a systematic review and meta-analysis","volume":"25","author":"S Murao","year":"2021","journal-title":"Crit Care"},{"issue":"10","key":"ref12","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1111\/1471-0528.17455","article-title":"Alternative routes for tranexamic acid treatment in obstetric bleeding (WOMAN-PharmacoTXA trial): a randomised trial and pharmacological study in caesarean section births","volume":"130","author":"H Shakur-Still","year":"2023","journal-title":"BJOG"},{"volume-title":"Births: provisional data for 2022","author":"B E Hamilton","key":"ref13"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/AOG.0000000000004972","article-title":"Postpartum hemorrhage trends and outcomes in the United States, 2000\u20132019","volume":"141","author":"C M Corbetta-Rastelli","year":"2023","journal-title":"Obstet Gynecol"},{"issue":"04","key":"ref15","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1007\/s11239-023-02785-y","article-title":"Recent trends in tranexamic acid use during postpartum hemorrhage in the United States","volume":"55","author":"E A Litman","year":"2023","journal-title":"J Thromb Thrombolysis"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1186\/s12884-023-05753-9","article-title":"Effect of preoperative prophylactic intravenous tranexamic acid on perioperative blood loss control in patients undergoing cesarean delivery: a systematic review and meta-analysis","volume":"23","author":"F Yang","year":"2023","journal-title":"BMC Pregnancy Childbirth"},{"issue":"06","key":"ref17","doi-asserted-by":"crossref","first-page":"100933","DOI":"10.1016\/j.ajogmf.2023.100933","article-title":"An update to tranexamic acid trends during the peripartum period in the United States, 2019 to 2021","volume":"5","author":"E K Sterling","year":"2023","journal-title":"Am J Obstet Gynecol MFM"},{"volume-title":"Management of the third stage of labor: prophylactic pharmacotherapy to minimize hemorrhage","author":"V Berghella","key":"ref18"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2353-0832.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T23:32:35Z","timestamp":1738711955000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2353-0832"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,26]]},"references-count":18,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2025,2,4]]},"published-print":{"date-parts":[[2025,2]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2353-0832","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"type":"print","value":"0735-1631"},{"type":"electronic","value":"1098-8785"}],"subject":[],"published-other":{"date-parts":[[2024,6,26]]},"published":{"date-parts":[[2024,6,26]]}}}