Postpartum hemorrhage (PPH) is a preventable complication, however, it remains being the leading cause of maternal mortality and morbidity worldwide including Thailand. A case-control study to examine the risk factors associated with PPH across the hospitals under the Ministry of Public Health in Thailand, was conducted. A total of 1833 patient birth records and hospital profiles including human and physical resources from 14 hospitals were obtained. A multiple logistic regression was used identifing the factors that are significantly associated with PPH. The results show that the rate of PPH varied across the hospitals ranging from 1.4 to 10.6%. Women with past history of PPH were more likely to have increased risk of having PPH by 10.97 times (95% CI 2.27,53.05) compared to those who did not. The odds of PPH was higher in district and general hospitals by 14 (95% CI 3.95,50.04) and 7 (95% CI 2.27,23.27) times respectively, compared to regional hospitals. The hospitals which had inadequate nurse midwife to patient ratio (OR 2.31,95% CI 1.08,4.92), lacked nurse midwives with working experience of 6–10 years (OR 2.35, 95% CI 1.41,3.92), as well as inadequate equipment and supplies for emergency obstetric care (OR 6.47, 95% CI 1.93,21.63), had significantly higher incidence of having PPH, respectively. This study provides interesting information that the rate of PPH varies across the hospitals in Thailand, in particular where essential nurse midwives, equipment, and supplies are limited. Therefore, improving health care services by allocating sufficient human and physical resources would contribute to significantly reduce this complication.

中文翻译：

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泰国14个地区，普通和地区医院产妇和卫生服务的产后出血预测指标

产后出血（PPH）是一种可预防的并发症，但是，它仍然是包括泰国在内的世界范围内孕产妇死亡率和发病率的主要原因。进行了一项病例对照研究，以检查泰国公共卫生部下属各医院与PPH相关的危险因素。总共获得了14家医院的1833名患者的出生记录和医院概况，包括人力和物力。使用多元逻辑回归确定与PPH显着相关的因素。结果显示，各医院的PPH发生率在1.4％至10.6％之间变化。与没有PPH病史的女性相比，具有PPH病史的女性更有可能发生PPH的风险增加了10.97倍（95％CI 2.27,53.05）。与地区医院相比，地区医院和综合医院中PPH的几率分别高14倍（95％CI 3.95,50.04）和7倍（95％CI 2.27,23.27）。护士助产士与患者的比例不足的医院（OR 2.31,95％CI 1.08,4.92），缺乏工作经验为6-10年的护士助产士（OR 2.35，95％CI 1.41,3.92），以及设备不足和紧急产科护理用品（OR 6.47，95％CI 1.93,21.63）分别具有较高的PPH发生率。这项研究提供了有趣的信息，即泰国各家医院的PPH率各不相同，尤其是在基本护士助产士，设备和物资有限的地方。因此，