{
  "abstract": "Background\n\nPostpartum hemorrhage (PPH) is a leading cause of maternal morbidity, most often from uterine atony. Carbetocin, a long-acting heat-stable oxytocin analogue, reduces blood loss at cesarean delivery in randomized trials, but real-world data are sparse from settings where carbetocin is self-paid and not yet routine, such as Taiwan. We examined the association between carbetocin and peri-operative hemoglobin change at cesarean delivery in a setting of rising, patient-funded use.Methods\n\nSingle-center retrospective cohort of deliveries between 2017 and 2025. Carbetocin (100 µg intravenously) was self-paid and chosen by the patient; comparators received the institutional standard (oxytocin alone at cesarean). The primary outcome was the peri-operative hemoglobin change (post- minus pre-delivery, g/dL) at cesarean delivery. Multivariable linear regression adjusted for age, BMI, parity, birth weight, and high-risk status, with calendar year added to address the secular trend in uptake; propensity-score inverse-probability weighting was a sensitivity analysis (complete-case). Because the recorded vaginal blood-loss field showed treatment-linked recording heterogeneity, only the binary PPH endpoint is reported for vaginal delivery.Results\n\nOf 6,266 deliveries with documented carbetocin status, 2,112 were cesarean. Among cesarean deliveries with paired peri-operative hemoglobin (carbetocin n = 734; no carbetocin n = 484; complete-case analytic n = 1,061), the median hemoglobin change was - 0.60 g/dL with carbetocin versus - 1.30 g/dL without; pre-delivery hemoglobin was identical between arms. The adjusted mean difference was + 0.79 g/dL (95% CI 0.65 to 0.94), consistent in low-risk (+ 0.84) and high-risk (+ 0.76) strata and under propensity weighting. A severe hemoglobin decline (≥ 2 g/dL) occurred in 11% versus 25% (supportive, sensitive to missing data). For vaginal delivery, PPH (≥ 500 mL) occurred in 3.2% versus 4.2% (year-adjusted odds ratio 0.68, 95% CI 0.46 to 1.01; not significant).Conclusions\n\nIn this non-randomized, self-paid cohort, carbetocin was associated with a smaller peri-operative hemoglobin decline at cesarean delivery, directionally consistent with randomized evidence; the magnitude was larger than pooled trial estimates and is likely inflated by selection. Carbetocin was not associated with a lower incidence of PPH. Findings are associations and require cautious interpretation.Trial registration\n\nNot applicable; this is a retrospective observational study and was not registered as a clinical trial.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Nursing, HungKuang University, Taichung, Taiwan.",
    "Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhonghe, New Taipei City, 23561, Taiwan.",
    "Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan.",
    "Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd., Zhonghe, New Taipei City, 23561, Taiwan. msp1107@gmail.com."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Shu-Ying Chen"
    },
    {
      "affs": [
        1
      ],
      "name": "Ming-Han Chang"
    },
    {
      "affs": [
        1
      ],
      "name": "Kuan-Ju Lai"
    },
    {
      "affs": [
        2
      ],
      "name": "Jung-Hsiu Hou"
    },
    {
      "affs": [
        3
      ],
      "name": "Shih-Peng Mao"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/adskygxsn54wx.bib",
  "cited_by": 0,
  "doi": "10.1186/s12884-026-09717-7",
  "fulltext_url": "https://europepmc.org/articles/PMC13688763",
  "id": "adskygxsn54wx",
  "issns": [
    "1471-2393"
  ],
  "landing_url": "https://europepmc.org/article/MED/42907989",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RG1-991"
    ],
    [
      "openalex",
      "2735|Maternal and fetal healthcare"
    ]
  ],
  "openalex": "W7171432430",
  "pdf_url": "https://europepmc.org/articles/PMC13688763?pdf=render",
  "pmcid": "PMC13688763",
  "pmid": "42907989",
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/adskygxsn54wx.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:57Z",
      "native_id": "MED:42907989",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42907989"
    },
    {
      "first_seen": "2026-10-30T13:46:36Z",
      "native_id": "b9b7615de986437abe5e430e338f9d1c",
      "source": "doaj",
      "url": "https://doi.org/10.1186/s12884-026-09717-7"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2735|Maternal and fetal healthcare",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Carbetocin and peri-operative hemoglobin change at cesarean delivery in a setting of self-paid use: an 8-year retrospective cohort study.",
  "title_text": "Carbetocin and peri-operative hemoglobin change at cesarean delivery in a setting of self-paid use: an 8-year retrospective cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:46:36Z",
  "url": "https://research.draconitic.com/paper/adskygxsn54wx",
  "venue": "BMC pregnancy and childbirth",
  "versions": []
}