{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T18:03:32Z","timestamp":1793642612063,"version":"4.5.1"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,7,10]],"date-time":"2018-07-10T00:00:00Z","timestamp":1531180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN268201100009I"],"award-info":[{"award-number":["HHSN268201100009I"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN268201100002I"],"award-info":[{"award-number":["HHSN268201100002I"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN26800002"],"award-info":[{"award-number":["HHSN26800002"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN26800003"],"award-info":[{"award-number":["HHSN26800003"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Obstetric hemorrhage (OH) and access to peripartum blood transfusion remains a global health challenge. The rates of peripartum transfusion in South Africa exceed those in high\u2010income countries despite comparable rates of OH. We sought to evaluate factors associated with peripartum transfusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>A case\u2010control study was conducted at four large South African hospitals. Transfused peripartum women (cases) and nontransfused controls were stratum matched 1:2 by hospital and delivery date. Data on obstetric, transfusion, and human immunodeficiency virus (HIV) history were abstracted from medical records. Blood was obtained for laboratory evaluation. We calculated unadjusted and adjusted odds ratios (ORs) for transfusion using logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 1200 transfused cases and 2434 controls were evaluated. Antepartum hemorrhage (OR, 197.95; 95% confidence interval [CI], 104.27\u2010375.78), hemorrhage with vaginal delivery (OR, 136.46; 95% CI, 75.87\u2010245.18), prenatal anemia (OR, 22.76; 95% CI, 12.34\u201041.93 for prenatal hemoglobin level\u2009&lt;\u20097 g\/dL), and failed access to prenatal care (OR, 6.71; 95% CI, 4.32\u201010.42) were the major risk factors for transfusion. Platelet (PLT) count (ORs, 4.10, 2.66, and 1.77 for \u226450 \u00d7 10<jats:sup>9<\/jats:sup>, 51 \u00d7 10<jats:sup>9<\/jats:sup>\u2010100 \u00d7 10<jats:sup>9<\/jats:sup>, and 101 \u00d7 10<jats:sup>9<\/jats:sup>\u2010150 \u00d7 10<jats:sup>9<\/jats:sup> cells\/L, respectively), HIV infection (OR, 1.29; 95% CI, 1.02\u20101.62), and admitting hospital (twofold variation) were also associated with transfusion. Mode of delivery, race, age category, gravidity, parity, gestational age, and birthweight were not independently associated with transfusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Major risk factors of peripartum transfusion in South Africa, namely, prenatal anemia and access to prenatal care, may be amenable to intervention. HIV infection and moderately low PLT count are novel risk factors that merit further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.14772","type":"journal-article","created":{"date-parts":[[2018,7,10]],"date-time":"2018-07-10T05:44:22Z","timestamp":1531201462000},"page":"2149-2156","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Risk factors for peripartum blood transfusion in South Africa: a case\u2010control study"],"prefix":"10.1111","volume":"58","author":[{"given":"Evan M.","family":"Bloch","sequence":"first","affiliation":[{"name":"Department of Pathology Johns Hopkins University School of Medicine Baltimore Maryland"},{"name":"Blood Systems Research Institute San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Ingram","sequence":"additional","affiliation":[{"name":"South African National Blood Service Johannesburg South Africa"},{"name":"South African Bone Marrow Registry Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Hull","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Chris Hani Baragwanath Hospital Soweto South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Fawcus","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Mowbray Maternity Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Anthony","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Groote Schuur Hospital Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randolph","family":"Green\u2010Thompson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology King Edward Hospital Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L.","family":"Crookes","sequence":"additional","affiliation":[{"name":"South African National Blood Service Johannesburg South Africa"},{"name":"Cryo\u2010Save Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solomuzi","family":"Ngcobo","sequence":"additional","affiliation":[{"name":"South African National Blood Service Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darryl","family":"V. Creel","sequence":"additional","affiliation":[{"name":"RTI international Rockville Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Courtney","sequence":"additional","affiliation":[{"name":"RTI international Rockville Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg R.M.","family":"Bellairs","sequence":"additional","affiliation":[{"name":"Western Province Blood Transfusion Service Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward L.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Blood Systems Research Institute San Francisco California"},{"name":"Departments of Laboratory Medicine and Epidemiology\/Biostatistics University of California San Francisco San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the South Africa Program of the NHLBI Recipient Epidemiology and Donor Evaluation Study\u2010III (REDS\u2010III)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,7,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.01866.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2006.04.016"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2009.02.002"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2004.07.012"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00601.x"},{"key":"e_1_2_8_7_1","first-page":"700","article-title":"Severe acute maternal morbidity and maternal death audit\u2014a rapid diagnostic tool for evaluating maternal care","volume":"93","author":"Cochet L","year":"2003","journal-title":"S Afr Med J"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1998.tb10262.x"},{"key":"e_1_2_8_9_1","first-page":"CD002042","article-title":"Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion","volume":"10","author":"Carson JL","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12531"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2014.10.012"},{"key":"e_1_2_8_12_1","first-page":"463","article-title":"HIV\/AIDS affects blood and blood product use at Groote Schuur Hospital, Cape Town","volume":"101","author":"Ntusi NB","year":"2011","journal-title":"S Afr Med J"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13040"},{"key":"e_1_2_8_14_1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1080\/01621459.1995.10476488","article-title":"A split questionnaire survey design","volume":"90","author":"Raghunathan TE","year":"1995","journal-title":"J Am Stat Assoc"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i03"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11121-007-0070-9"},{"key":"e_1_2_8_17_1","unstructured":"RubinDB Schafer JL. 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