{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T13:32:12Z","timestamp":1782567132858,"version":"3.54.5"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The National Science Foundation of China","award":["No. 71804162"],"award-info":[{"award-number":["No. 71804162"]}]},{"DOI":"10.13039\/501100010248","name":"Zhejiang Province Public Welfare Technology Application Research Project","doi-asserted-by":"publisher","award":["No. LGF22H260007"],"award-info":[{"award-number":["No. LGF22H260007"]}],"id":[{"id":"10.13039\/501100010248","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>Postpartum hemorrhage (PPH) is a leading cause of maternal mortality worldwide, and its risk factors vary regionally. This study assessed the incidence and determinants of PPH in Zhejiang Province, China.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a cross-sectional study using data from the Maternity Near Miss Surveillance System in Zhejiang Province, collected from January to December 2020. The cohort included 56,014 pregnant women at a gestational age of 28 weeks or more. PPH was defined as blood loss of \u2265500\u2009mL for vaginal deliveries and \u22651,000\u2009mL for cesarean sections within 24\u2009h of delivery. Logistic regression analyzed the risk factors for PPH.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Of the pregnant women, 2,016 (3.60%) experienced PPH. The mortality rate associated with PPH was 1.74 per 100,000 live births. Significant independent risk factors included multiple births (OR 3.10; 95% CI 2.42\u20133.98; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01), vaginal delivery (OR 3.00; 95% CI 2.62\u20133.42; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01), macrosomia (OR 2.30; 95% CI 1.97\u20132.68; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01), hypertensive disorders of pregnancy (OR 1.79; 95% CI 1.50\u20132.13; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01), and a lower educational level (OR 1.20; 95% CI 1.07\u20131.36; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The incidence and mortality rates of PPH in Zhejiang Province are low. Identified risk factors such as multiple births, vaginal delivery, macrosomia, hypertensive disorders, and lower education level can guide interventions to mitigate PPH risk.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0323190","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T17:24:32Z","timestamp":1748539472000},"page":"e0323190","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Postpartum hemorrhage incidence and risk factors: Evidence from a multicenter study in Zhejiang Province, 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