Predictors of Primary Postpartum Haemorrhage in aTertiary Teaching Hospital in Ekiti State, Nigeria: A Facility-Based Analytical Study

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Background: Postpartum haemorrhage (PPH) is a major contributor to maternal morbidity and mortality, especially in LMICs. Identifying context-specific predictors in tertiary facilities supports targeted prevention, early detection, and timely first-response care bundles consistent with contemporary guidance.Subjects and Method: This prospective facility-based analytical cohort study evaluated associations between socio-demographic characteristics, antepartum risk factors, and labour events with occurrence of PPH among 308 parturients at Ekiti State University Teaching hospital. Bivariate associations were assessed using chi-square tests, and independent predictors were modelled using binary logistic regression with adjusted odds ratios (aOR), 95% confidence intervals (CI), and p-values interpreted at α=0.05.Results: Thirty women developed PPH (9.7%) at Ekiti State University Teaching Hospital. Also, ethnicity was the only socio-demographic factor associated with PPH (p=0.047). Obstetric and intrapartum variables showed strong associations. In multivariable analysis, gravidity 3–4 (aOR 8.15; p=0.001), parturients who have been pregnant more than four times (aOR 59.40; p<0.001), grand multiparity (aOR 16.875; p<0.001), fetal macrosomia (aOR 12.63; p<0.001), uterine fibroids (aOR 2.95; p=0.024), antepartum haemorrhage (aOR 22.91; p<0.001), prolonged labour (aOR 13.65; p<0.001), labour duration >12 hours (aOR 15.33; p=0.003), perineal tear (aOR 10.43; p<0.001), birthweight >4.0 kg (aOR 13.02; p<0.001), and accumulation of ≥2 or ≥3 risk factors (aOR 5.00 and 43.81; p=0.010 and <0.001) independently predicted PPH.Conclusion: In this tertiary hospital cohort, PPH risk was driven primarily by high gravidity/parity, placental-bleeding antecedents, macrosomia, and labour duration/trauma variables. Therefore, risk-factor triggered preparedness and objective early detection with rapid bundled response are warranted for high-risk parturients.

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