{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:37:22Z","timestamp":1790703442288,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T00:00:00Z","timestamp":1680048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To adequately predict significant postpartum hemorrhage (PPH) at hospital admission, we evaluated and compared the accuracy of three risk assessment tools: 1. California Maternal Quality Care Collaborative (CMQCC), 2. American College of Obstetrics and Gynecology Safe Motherhood Initiative (ACOG SMI) and 3. Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>This is a retrospective cohort study of people who delivered liveborn infants from January 2018 to June 2021 at our center. Patients with comorbidities necessitating higher hemoglobin values, those who refused blood transfusions, and missing pertinent data were excluded. Significant PPH was defined as a blood transfusion within 48\u2009hours following delivery. Diagnostic statistics were calculated for each tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 11,679 included pregnancies, 232 (1.9%) people had significant PPH. Amongst those diagnosed as high\u2010risk by the CMQCC tool, 67\/1485 (4.5%) had significant PPH; 62\/1672 (3.7%) by the ACOG SMI tool, and 85\/1864 (4.6%) by the AWHONN tool had significant PPH. All tools have low sensitivity and high negative predictive values. The area under the receiver operating characteristics curve of the three tools is moderately poor (CMQCC: 0.58, ACOG SMI: 0.55, AWHONN:0.61).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Upon admission to labor and delivery, all three studied tools are poor predictors of significant PPH. The development and validation of better PPH risk stratification tools are required with the inclusion of additional important variables.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.17320","type":"journal-article","created":{"date-parts":[[2023,3,29]],"date-time":"2023-03-29T12:35:15Z","timestamp":1680093315000},"page":"1005-1010","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Comparison of three antepartum risk assessment tools to predict significant postpartum hemorrhage in livebirths"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3283-3712","authenticated-orcid":false,"given":"Vani C.","family":"Movva","sequence":"first","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Geisinger  Danville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Bringman","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Geisinger  Danville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Young","sequence":"additional","affiliation":[{"name":"Biostatistics Core, Department of Population Health Sciences Geisinger  Danville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia","family":"Gray","sequence":"additional","affiliation":[{"name":"Phenomic Analytics &amp; Clinical Data Core, Department of Population Health Sciences Geisinger  Danville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Dhanya","family":"Mackeen","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Geisinger  Danville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Paglia","sequence":"additional","affiliation":[{"name":"Division of Maternal\u2010Fetal Medicine Geisinger  Danville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"crossref","unstructured":"SayL ChouD GemmillA et al.Articles global causes of maternal death: a WHO systematic analysis.2014.","DOI":"10.1016\/S2214-109X(14)70227-X"},{"issue":"500","key":"e_1_2_6_3_1","first-page":"1993","article-title":"Data on selected pregnancy complications in the United States","volume":"2019","author":"Centers for Disease Control and Prevention","year":"2017","journal-title":"Hypertens Disord"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.07.007"},{"key":"e_1_2_6_5_1","first-page":"1","article-title":"Provision of care, treatment, and services standards for maternal safety","volume":"24","author":"Joint Commission","year":"2019","journal-title":"Require Ration Ref"},{"key":"e_1_2_6_6_1","unstructured":"BinghamD MelsopK MainE.CMQCC Obstetric Hemorrhage Hospital Level Implementation Guide. Available athttps:\/\/www.cmqcc.org\/resource\/1489\/downloadRetrieved February 20 2023."},{"key":"e_1_2_6_7_1","unstructured":"American Congress of Obstetricians and Gynecologists.Maternal safety bundle for obstetric hemorrhage. Available athttps:\/\/www.acog.org\/-\/media\/Districts\/District-II\/Public\/SMI\/v2\/HEMSlidRetrieved February 20 2023."},{"key":"e_1_2_6_8_1","unstructured":"The AWHONN Postpartum Hemorrhage Project.Postpartum hemorrhage (PPH) risk assessment table 1.0. Available athttps:\/\/mygnosis.com\/Content\/Chunks\/3504\/assets\/pdfs\/PPH_Risk_AssessmentRetrieved February 20 2023."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.4037\/aacnacc2018966"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182941c78"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1710501"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002236"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1712166"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16216"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.17320","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T20:20:59Z","timestamp":1692649259000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.17320"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,29]]},"references-count":13,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1111\/trf.17320"],"URL":"https:\/\/doi.org\/10.1111\/trf.17320","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,29]]},"assertion":[{"value":"2022-06-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}