Risk factors for self-reported postpartum hemorrhage in Ga East, Ghana

Objective: To document the prevalence of self-reported postpartum hemorrhage (PPH) in Ga East, Accra, Ghana, and examine the demographic, biological, and social risk factors for PPH. Methods: The present study was a cross-sectional secondary analysis of data collected during 2010–2012 from the Ghana Essential Health Interventions Program, a quasi-experimental interventional study surveying households in the urban Ga East Municipal District. The analysis included data from randomly selected parous women of childbearing age (15–49 years), excluding those with a history of abortion (spontaneous or induced) or stillbirth. The χ² test and logistic regression were used to identify significant risk factors for self-reported PPH. Results: The current analysis included 2136 women. Self-reported PPH was recorded for 95 (4.4%) participants. The maternal age at delivery, the duration of labor, and the number of skilled delivery providers were significantly associated with self-reported PPH. Prolonged labor (odds ratio 3.70, 95% confidence interval 2.27–5.94; P<0.001) and maternal age (odds ratio 0.96, 95% confidence interval 0.94–0.99; P=0.020) were predictors of self-reported PPH. Conclusion: Prolonged labor and younger maternal age were related to a higher burden of reported PPH. These findings were congruent with global and regional data on the prevalence and risk factors for objectively measured PPH and could help focus intervention strategies to high-risk groups, particularly in resource-limited settings.