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\begin{document}

\title{Predicting Postpartum Haemorrhage: A systematic review of prognostic
models}



\author[1]{Bethany Carr}%
\author[1]{Maryam Jahangirifar}%
\author[1]{Ann Nicholson}%
\author[2]{Ben Mol}%
\author[1]{Wentao Li}%
\author[3]{Sharon Licqurish}%
\affil[1]{Monash University}%
\affil[2]{Monash University Faculty of Medicine Nursing and Health Sciences}%
\affil[3]{Monash Centre for Health Research and Implementation}%


\vspace{-1em}



  
  \date{May 26, 2024}


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\begin{abstract}
Background: Postpartum Haemorrhage (PPH) remains a leading cause of
maternal mortality and morbidity worldwide, and the rate is increasing.
Using a reliable predictive model could identify those at risk, support
management and treatment, and improve maternal outcomes. Objectives: To
systematically identify and appraise existing prognostic models for PPH
and ascertain suitability for clinical use. Search strategy: MEDLINE,
CINAHL, Embase, and the Cochrane Library were searched using
combinations of terms and synonyms including `postpartum haemorrhage',
`prognostic model', and `risk factors' that were developed from a
scoping review. Selection Criteria: Observational or experimental
studies describing a prognostic model for risk of PPH, published in
English. Data Collection and Analysis: The Critical Appraisal and Data
Extraction for Systematic Reviews of Prediction Modelling Studies
checklist informed data extraction and Prediction Model Risk of Bias
Assessment Tool guided analysis. Main Results: 16 studies met the
inclusion criteria after screening 1612 records. All studies were
hospital settings from 8 different countries. Models were developed for
women who experienced vaginal birth (n=7), caesarean birth(n=2), any
type of birth(n=2), hypertensive disorders(n=1) and those with placental
abnormalities(n=4). All studies were at high risk of bias due to use of
inappropriate analysis methods or omission of important statistical
considerations or suboptimal validation. Conclusions: No existing
prognostic models for PPH are ready for clinical application. Future
research is needed to externally validate existing models and
potentially develop a new model that is reliable and applicable to
clinical practice. Funding: This study received no funding. Keywords:
Postpartum haemorrhage, prognostic model, prediction tool.%
\end{abstract}%



\sloppy


\textbf{Predicting Postpartum Haemorrhage: A systematic review of
prognostic models}

Bethany L. Carr \textsuperscript{1*}, Maryam
Jahangirifar\textsuperscript{1}, Ann E. Nicholson\textsuperscript{2},
Wentao Li\textsuperscript{3}, Ben W. Mol\textsuperscript{3}, Sharon
Licqurish\textsuperscript{1,4}

\emph{\textsuperscript{1} School of Nursing and Midwifery, Monash
University, Clayton, Victoria, Australia}

\emph{\textsuperscript{2}Faculty of Information Technology, Monash
University, Clayton, Victoria, Australia}

\emph{\textsuperscript{3}Department of Obstetrics and Gynaecology,
School of Medicine, Monash University, Clayton, Victoria, Australia}

\emph{\textsuperscript{4}Monash Centre for Health Research \&
Implementation, Monash Health, Clayton, Victoria, Australia}

* Corresponding author at: Nursing and Midwifery, Faculty of Medicine,
Nursing and Health Sciences, Monash University, 35 Rainforest Walk,
Clayton Campus, Clayton VIC 3800

Ph. 61 3 9902 0367

\emph{E-mail address} : bethany.carr@monash.edu

Running title: Review of models predicting PPH

\textbf{Hosted file}

\verb`Main Document.doc`  available at \url{https://authorea.com/users/423370/articles/528816-predicting-postpartum-haemorrhage-a-systematic-review-of-prognostic-models}

\textbf{Hosted file}

\verb`Figure 1 PRISMA_2020_flow.docx`  available at \url{https://authorea.com/users/423370/articles/528816-predicting-postpartum-haemorrhage-a-systematic-review-of-prognostic-models}

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