{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:36:53Z","timestamp":1790703413080,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T00:00:00Z","timestamp":1596585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Postpartum haemorrhage (PPH) causes substantial morbidity and mortality worldwide. A reliable prognostic tool for PPH has potential to aid prevention efforts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Systematically to identify and appraise prognostic modelling studies for prediction of PPH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>MEDLINE, Embase, CINAHL and the Cochrane Library were searched using a combination of terms and synonyms including \u2018prediction tool\u2019, \u2018risk score\u2019 and \u2018postpartum haemorrhage\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>Any observational or experimental study developing a prognostic model for women's risk of PPH. English language publications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Predesigned data extraction form to record: data source; participant criteria; outcome; candidate predictors; actual predictors; sample size; missing data; model development; model performance; model evaluation; interpretation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Of 2146 citations screened, 14 studies were eligible for inclusion. Studies addressed populations of women who experienced placenta praevia, placenta accreta spectrum, vaginal birth, caesarean birth (CS) and the general obstetric population. All studies were at high risk of bias due to low sample size, no internal validation, suboptimal or no external validation or no reporting or handling of missing data. Five studies raised applicability concerns. Three externally validated and three internally validated studies show potential for robust external validation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Of 14 prognostic models for PPH risk, three have some potential for clinical use: in CS, in placenta accreta spectrum disorders with MRI placental Evaluation and in placenta praevia. Future research requires robust internal and external validation of existing tools and development of a model for use in the general obstetric population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Current PPH prediction tools need external validation: one for CS, one for placenta praevia and one for placenta accreta. Tools are needed for labouring women.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16379","type":"journal-article","created":{"date-parts":[[2020,6,23]],"date-time":"2020-06-23T23:41:32Z","timestamp":1592955692000},"page":"46-53","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":123,"title":["Predicting risk of postpartum haemorrhage: a systematic review"],"prefix":"10.1111","volume":"128","author":[{"given":"C","family":"Neary","sequence":"first","affiliation":[{"name":"Paediatric Surgery NHS Greater Glasgow and Clyde Royal Hospital for Children in Glasgow Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Naheed","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology NHS Grampian Aberdeen Maternity Hospital Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DJ","family":"McLernon","sequence":"additional","affiliation":[{"name":"Medical Statistics Team Institute of Applied Health Sciences University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Black","sequence":"additional","affiliation":[{"name":"Aberdeen Centre for Women's Health Research Aberdeen Maternity Hospital University of Aberdeen Aberdeen UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,5]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"104","volume-title":"Saving Lives, Improving Mothers' Care\u2013\u2013Lessons Learned to Inform Maternity Care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2013\u201315","author":"Knight M","year":"2017"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68397-9"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-9-55"},{"issue":"2","key":"e_1_2_6_5_1","first-page":"CD003249","article-title":"Treatment for primary postpartum haemorrhage","author":"Mousa HA","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j3875"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-1217-0"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12636"},{"key":"e_1_2_6_9_1","first-page":"218","article-title":"Predictive and prognostic models: implications for healthcare decision\u2010making in a modern recession","volume":"2","author":"Vogenberg FR","year":"2009","journal-title":"Am Health Drug Benefits"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.06.013"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(03)00207-5"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001744"},{"key":"e_1_2_6_14_1","unstructured":"NearyC BlackM.A systematic review of risk prediction for postpartum haemorrhage. 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