{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:55:44Z","timestamp":1773014144652,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Secondary postpartum haemorrhage (PPH) complicates approximately 1% of pregnancies and can cause significant morbidity. Understanding predisposing factors may aid its prevention and management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To identify and assess risk factors for presentation to the emergency department with secondary PPH, including factors associated with increased severity and need for surgical management or inpatient care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective observational study, patients who presented to a metropolitan Melbourne women's hospital (\u2018Level 6\u2019 maternity referral centre) with secondary PPH between 1\/7\/2020 and 31\/12\/2021 were eligible for recruitment. Prospective clinical and demographic data was collected at time of emergency presentation; antenatal and intrapartum information were collected by review of medical records. Antenatal, birth and postpartum variables of those identified as presenting with a secondary PPH were compared with control participants who birthed at the institution in the same period. Comparisons were made using chi\u2010square tests, independent sample\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests and Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests as appropriate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      168 patients who experienced a secondary PPH were recruited and compared with 9491 controls. Factors associated with secondary PPH included younger maternal age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), lower parity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013), higher plurality (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), being born in Australia (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008), incomplete placenta and\/or membranes (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), greater blood loss at birth (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014) and infant formula feeding on discharge (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). Some of these factors, as well as others, were also associated with increased severity of secondary PPH, surgical management or inpatient care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Secondary PPH is a significant problem with associated risk factors. Further research should look at preventative mechanisms for secondary PPH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>Australian New Zealand Clinical Trials Registry registration number: ACTRN12622000039785<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajo.70075","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T11:35:56Z","timestamp":1763033756000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors for Secondary Postpartum Haemorrhage: Preliminary Data for a Longitudinal Prospective Cohort Study Involving Women Presenting to a Single Tertiary Women's Hospital"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5919-6771","authenticated-orcid":false,"given":"Jessica","family":"Anderson","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Mercy Hospital for Women  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0938-1802","authenticated-orcid":false,"given":"Nicole","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Mercy Hospital for Women  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3434-5870","authenticated-orcid":false,"given":"Rachael","family":"Fox","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Mercy Hospital for Women  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Mercy Hospital for Women  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Cvejic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, School of Public Health University of Sydney  Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5742-9148","authenticated-orcid":false,"given":"Samantha S.","family":"Mooney","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Mercy Hospital for Women  Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002351"},{"key":"e_1_2_7_3_1","volume-title":"WHO Guidelines for the Management of Postpartum Haemorrhage and Retained Placenta","author":"G\u00fclmezoglu A. 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