{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:25:59Z","timestamp":1787509559012,"version":"build-2736575974"},"reference-count":21,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T00:00:00Z","timestamp":1695513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto de Salud Carlos III (ISCIII)","award":["PI21\/01244"],"award-info":[{"award-number":["PI21\/01244"]}]},{"name":"Instituto de Salud Carlos III (ISCIII)","award":["P2022\/BMD-7321"],"award-info":[{"award-number":["P2022\/BMD-7321"]}]},{"name":"European Union","award":["PI21\/01244"],"award-info":[{"award-number":["PI21\/01244"]}]},{"name":"European Union","award":["P2022\/BMD-7321"],"award-info":[{"award-number":["P2022\/BMD-7321"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Postpartum hemorrhage (PPH) remains a significant obstetric emergency worldwide and a leading cause of maternal death. However, it is commonly underreported, which can represent a major concern for maternal morbidity and mortality. This retrospective case series study analyzed patients with red blood cell transfusion (RBCt) in the postpartum period over a four-year interval at a specific center. A total of 18,674 patients delivered between January 2018 and December 2021. Patients with postpartum RBCt were classified into two groups: those with identified PPH (i-PPH) and those without (non-i-PPH). Clinical variables, delivery details, blood loss data, and treatment information were collected. Statistical analysis involved a comparison of variables between the i-PPH and non-i-PPH groups. Univariate and multivariate analyses were performed, aiming to identify significant associations between the clinical variables and a lack of PPH identification. The incidence of RBCt was 1.26% (236 cases). Patients receiving RBCt had higher rates of cesarean delivery, twin pregnancy, labor induction, and previous cesarean section. Among patients with postpartum RBCt, 34.3% lacked an identified PPH. The rarity of postpartum RBCt contrasts with the increasing rates of PPH, highlighting the importance of diagnosing PPH and postpartum anemia. A strategy of systematic quantification of blood loss during delivery could help detect PPH and anemia before adverse consequences occur.<\/jats:p>","DOI":"10.3390\/jcm12196175","type":"journal-article","created":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T10:48:31Z","timestamp":1695552511000},"page":"6175","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Red Blood Cell Transfusion after Postpartum Hemorrhage: Clinical Variables Associated with Lack of Postpartum Hemorrhage Etiology Identification"],"prefix":"10.3390","volume":"12","author":[{"given":"Francisco Javier","family":"Ruiz-Labarta","sequence":"first","affiliation":[{"name":"Department of Public and Maternal and Child Health, Faculty of Medicine and Health Science, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain"},{"name":"Department of Obstetrics and Gynecology, University Hospital Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Health Research Institute Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roc\u00edo","family":"Aracil Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Public and Maternal and Child Health, Faculty of Medicine and Health Science, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain"},{"name":"Department of Obstetrics and Gynecology, University Hospital Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Health Research Institute Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ainoa","family":"S\u00e1ez Prat","sequence":"additional","affiliation":[{"name":"Department of Public and Maternal and Child Health, Faculty of Medicine and Health Science, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain"},{"name":"Department of Obstetrics and Gynecology, University Hospital Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Health Research Institute Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"P\u00e9rez Burrel","sequence":"additional","affiliation":[{"name":"Department of Public and Maternal and Child Health, Faculty of Medicine and Health Science, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain"},{"name":"Department of Obstetrics and Gynecology, University Hospital Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Health Research Institute Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Manuel","family":"Pina Moreno","sequence":"additional","affiliation":[{"name":"Department of Public and Maternal and Child Health, Faculty of Medicine and Health Science, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain"},{"name":"Department of Obstetrics and Gynecology, University Hospital Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Health Research Institute Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes","family":"S\u00e1nchez Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Public and Maternal and Child Health, Faculty of Medicine and Health Science, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain"},{"name":"Department of Obstetrics and Gynecology, University Hospital Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Health Research Institute Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Pilar","family":"Pintado Recarte","sequence":"additional","affiliation":[{"name":"Department of Public and Maternal and Child Health, Faculty of Medicine and Health Science, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain"},{"name":"Department of Obstetrics and Gynecology, University Hospital Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Health Research Institute Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0904-6198","authenticated-orcid":false,"given":"Natalio","family":"Garc\u00eda-Honduvilla","sequence":"additional","affiliation":[{"name":"Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcal\u00e1, Alcal\u00e1 de Henares, 28801 Madrid, Spain"},{"name":"Ram\u00f3n y Cajal Institute of Healthcare Research (IRYCIS), 28034 Madrid, Spain"},{"name":"University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2588-1708","authenticated-orcid":false,"given":"Miguel A.","family":"Ortega","sequence":"additional","affiliation":[{"name":"Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcal\u00e1, Alcal\u00e1 de Henares, 28801 Madrid, Spain"},{"name":"Ram\u00f3n y Cajal Institute of Healthcare Research (IRYCIS), 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9693-5649","authenticated-orcid":false,"given":"Javier","family":"Anguita Velasco","sequence":"additional","affiliation":[{"name":"Health Research Institute Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Department of Haematology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"P\u00e9rez Corral","sequence":"additional","affiliation":[{"name":"Health Research Institute Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Department of Haematology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coral","family":"Bravo","sequence":"additional","affiliation":[{"name":"Department of Public and Maternal and Child Health, Faculty of Medicine and Health Science, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain"},{"name":"Department of Obstetrics and Gynecology, University Hospital Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Health Research Institute Gregorio Mara\u00f1\u00f3n, 28009 Madrid, Spain"},{"name":"Maternal and Infant Research Investigation Unit, Alonso Family Foundation (UDIMIFFA), 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6320-2668","authenticated-orcid":false,"given":"Juan A.","family":"De Le\u00f3n-Luis","sequence":"additional","affiliation":[{"name":"Department of Public and Maternal and Child Health, Faculty of Medicine and Health Science, School of Medicine, Complutense University of 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