{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T04:18:25Z","timestamp":1792729105696,"version":"4.5.0"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001700","name":"The Ministry of Education, Science, Sports and Culture","doi-asserted-by":"crossref","award":["21K09473"],"award-info":[{"award-number":["21K09473"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Given Japan\u2019s unique social background, it is critical to understand the current risk factors for postpartum hemorrhage (PPH) to effectively manage the condition, especially among specific groups. Therefore, this study aimed to identify the current risk factors for PPH during planned cesarean section (CS) in Japan. This multicenter retrospective cohort study was conducted in two tertiary maternal-fetal medicine units in Fukushima, Japan and included 1,069 women who underwent planned CS between January 1, 2013, and December 31, 2022. Risk factors for PPH (of &gt; 1000 g and &gt; 1500 g) were assessed using multivariate logistic regression analysis, considering variables such as maternal age, parity, assisted reproductive technology (ART) pregnancy, pre-pregnancy body mass index (BMI), uterine myoma, placenta previa, gestational age at delivery, birth weight categories, and hypertensive disorders of pregnancy (HDP). Multivariate linear regression analyses were conducted to predict estimated blood loss during planned CS. ART pregnancy, a pre-pregnancy BMI of 25.0\u201329.9 kg\/m<jats:sup>2<\/jats:sup>, and uterine myoma increased PPH risk at various levels. Maternal smoking increased the risk of &gt;1500 g PPH (adjusted odds ratio: 3.09, 95% confidence interval [CI]: 1.16\u20138.20). Multivariate linear analysis showed that advanced maternal age (B: 83 g; 95% CI: 27\u2013139 g), ART pregnancy (B: 239 g; 95% CI: 121\u2013357 g), pre-pregnancy BMI of 25.0\u201329.9 kg\/m<jats:sup>2<\/jats:sup> (B: 74 g; 95% CI: 22\u2013167 g), uterine myoma (B: 151 g; 95% CI: 47\u2013256 g), smoking (B: 107 g; 95% CI: 13\u2013200 g), and birth weight &gt; 3,500 g (B: 203 g; 95% CI: 67\u2013338 g) were associated with blood loss during planned CS. Considering a patient\u2019s clinical characteristic may help predict bleeding in planned CSs and help improve patient safety.<\/jats:p>","DOI":"10.1371\/journal.pone.0306488","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T18:19:20Z","timestamp":1720549160000},"page":"e0306488","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Predicting postpartum hemorrhage in women undergoing planned cesarean section: A multicenter retrospective cohort study in Japan"],"prefix":"10.1371","volume":"19","author":[{"given":"Tomoko","family":"Yamaguchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7782-3396","authenticated-orcid":true,"given":"Hyo","family":"Kyozuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momoka","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Hiraiwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Murata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misa","family":"Sugeno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumihiro","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toma","family":"Fukuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Yasuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fujimori","family":"Keiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhisa","family":"Nomura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,7,9]]},"reference":[{"key":"pone.0306488.ref001","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1111\/1471-0528.15927","article-title":"Massive blood transfusion in relation to delivery: incidence, trends and risk factors: a population-based cohort study.","volume":"126","author":"L Thurn","year":"2019","journal-title":"BJOG."},{"key":"pone.0306488.ref002","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1016\/S0140-6736(06)68397-9","article-title":"WHO analysis of causes of maternal death: a systematic review","volume":"367","author":"KS Khan","year":"2006","journal-title":"Lancet"},{"issue":"449","key":"pone.0306488.ref003","first-page":"e441","article-title":"Incidence, risk factors, and temporal trends in severe postpartum hemorrhage.","volume":"209","author":"MS Kramer","year":"2013","journal-title":"Am J Obstet Gynecol"},{"key":"pone.0306488.ref004","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1002\/ijgo.12982","article-title":"Association between perinatal anemia and postpartum depression: A prospective cohort study of Japanese women.","volume":"148","author":"Y Maeda","year":"2020","journal-title":"Int J Gynaecol Obstet"},{"key":"pone.0306488.ref005","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1097\/GRF.0b013e3181cc406d","article-title":"Postpartum hemorrhage: epidemiology, risk factors, and causes.","volume":"53","author":"Y Oyelese","year":"2010","journal-title":"Clin Obstet Gynecol"},{"key":"pone.0306488.ref006","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1111\/j.1600-0412.2011.01107.x","article-title":"Postpartum hemorrhage\u2014update on problems of definitions and diagnosis.","volume":"90","author":"WH Rath","year":"2011","journal-title":"Acta Obstet Gynecol Scand"},{"key":"pone.0306488.ref007","first-page":"1104","article-title":"[Obstetric and anesthetic specificities in the management of a postpartum hemorrhage (PPH) associated with cesarean section].","volume":"43","author":"O Parant","year":"2014","journal-title":"J Gynecol Obstet Biol Reprod. 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