Hubungan Kadar Hemoglobin Maternal pada Trimester Ketiga dengan Kejadian Postpartum Hemorrhage di Rumah Sakit Prof Chairuddin Panusunan Lubis Universitas Sumatera Utara

Abstract

Background. Postpartum hemorrhage (PPH) is one of the leading causes of maternal morbidity and mortality worldwide, especially in low- and middle-income countries. Maternal hemoglobin levels during the third trimester play a crucial role in maintaining uterine oxygenation and contractility. Low hemoglobin or anemia increases the risk of uterine atony and subsequent PPH. Objective. To analyze the relationship between maternal hemoglobin levels in the third trimester and the incidence of postpartum hemorrhage among mothers undergoing cesarean section at the Prof. dr. Chairuddin P. Lubis Universitas Sumatera Utara Hospital, Universitas Sumatera Utara, Medan, 20155, INDONESIA. Methods. This study is an analytical observational research with a cross-sectional design using secondary data from 200 mothers who delivered between January 2023 and August 2025. Hemoglobin levels (normal: >11 g/dL; low: <11 g/dL) and the occurrence of PPH (>1000 mL blood loss) were analyzed using the Chi-square test with a significance level of p<0.05. Results. Of the 200 subjects, 114 (57.0%) had low hemoglobin levels, while 86 (43.0%) had normal hemoglobin levels. The incidence of PPH was significantly higher among mothers with low hemoglobin levels (88.0%) compared to those with normal levels (25.0%). Chi-square analysis demonstrated a significant association between hemoglobin levels and the incidence of PPH (p<0,001), with an odds ratio (OR = 3.163), indicating that mothers with low hemoglobin levels were approximately three times more likely to experience PPH compared to those with normal levels (95% CI: 1.2–5.2). Conclusion. There is a strong and statistically significant relationship between low maternal hemoglobin levels in the third trimester and the incidence of postpartum hemorrhage. Regular monitoring and early management of anemia during pregnancy are essential preventive measures to reduce the risk of PPH and improve maternal outcomes.