Blood loss at delivery and serum calcium levels of Navajo women.
Creators: name: Wilson, Ursula Maria Knoki
Publisher: name: University of Utah
Year: 2012
Subjects: Blood
Childbirth
Navajo Indians

description: Serum calcium levels of Navajo women were obtained during the ante partum period to study their relationship to blood loss during the first 24 hours of the postpartum period.  A total of 35 expectant mothers ranging in age from 17 to 36 years participated in the study.  Blood specimens for serum calcium analysis were obtained upon admission to the obstetric ward at Shiprock Indian Hospital and just prior to the infusion of intravenous therapy solutions.  The serum samples were mailed to Tuba City Indian Hospital, Tuba City, Arizona for multiphasic analyses by the TECHICON® SMA 12/60 System.  Blood loss was measured, immediately after delivery, by weighing the blood-stained obstetric linen and containers for collection of blood.  A pharmaceutical gram scale was used to determine weights.  Linen items and containers for blood loss were weighted before and after use.   The differences were totaled and recorded in grams.  The total gram weight of the items was then converted to milliliters of blood loss.  In addition, blood was estimated by the clinician who attended the delivery.  Hematocrits were obtained before delivery and 24 hours after delivery as another measure of blood loss.  Other factors which may possible influence the occurrence of postpartum hemorrhage are discussed, namely:  complications of labor and delivery, the duration of labor, the history of family bleeding problems, and the use of aspirin.  Data collection methods involved medical records review, individual participant interview, and laboratory analyses.  The statistical methods utilized in this study were Pearson's product-moment correlation coefficient and one-way analysis of variance (ANOVA).  Pearson's was used to test the relationship between serum calcium levels and postpartum blood loss.  The null hypothesis that there in no relationship between serum calcium levels of Navajo women prior to delivery and the amount of blood loss they sustain during delivery and for 24 hours thereafter, is supported as true (r=.16, p=NS).  One-way ANOVA was applied to each of three variables:  serum calcium levels before delivery, measured blood loss, and estimated blood loss; with use or non-use of aspirin.  The results indicated that the observed F ratios (F=2.06, F=.856, and F=.467, respectively), were not significant.  The null hypotheses corresponding to the three variables are accepted as true.  Possible explanations for the non-significant relationship found between the pre-delivery serum calcium levels and measured or estimated blood loss in the sampled 35 Navajo women were:  1. Educational and income levels were not included in the demographic data collection.  These factors have influenced the outcome of the study.  2. Forty percent of the mothers took prenatal vitamins and iron supplementation which also may have influenced the outcome of the study.  3. Eighty percent of the participants were residents of the Shiprock community, an agriculturally rich area enabling them to have access to calcium rich foods.  4. Shiprock Navajos have better access to nearby towns where a greater variety of food is available than more isolated Navajo who buy at trading posts.