Tranexamic acid for postpartum bleeding: a systematic review and individual patient data meta-analysis of randomised controlled trials
Pooled result · Life-threatening bleedingResult — go to the resultPooled odds ratio 0.77 95% CI 0.63–0.93Authors' conclusion
Tranexamic acid reduces the risk of life-threatening postpartum bleeding. We found no evidence that tranexamic acid increases the risk of thrombosis.
Study context
- Population
- Women giving birth
- Participants
- 54,404 women · 5 trials
- Comparison
- Tranexamic acid vs placebo
- Tranexamic acidn = 27,300
- Placebon = 27,093reference
- Outcome
- Life-threatening bleeding and thromboembolic events (co-primary)
Methodological detailsplacebo-controlled trials, one-stage model, All trials low risk of bias, individual patient data (IPD) for 43 409 women from 4 trials; aggregate data on 10 995 women from 1 trial
- Placebo-controlled trials
- One-stage model
- All trials low risk of bias
- IPD for 43 409 women from 4 trials; aggregate data on 10 995 women from 1 trial
Pooled result
Life-threatening bleeding
Pooled odds ratio
0.77
95% CI 0.63–0.93
P = 0.008
Events by group
Tranexamic acid vs Placebo
pooled OR 0.77 (95% CI 0.63–0.93); P = 0.008
As reported in the abstract
Safety
| Outcome | Tranexamic acid | Placebo | Pooled OR (CI) | P value | |
|---|---|---|---|---|---|
| Fatal or non-fatal thromboembolic events (co-primary)26 571 vs 26 373 women · no significant heterogeneity in subgroup analyses | 0.2% | 0.2% | 0.96 (0.65–1.41) | P = 0.82 | |
| 0.512Pooled odds ratio (log scale) |
Original publication
Tranexamic acid for postpartum bleeding: a systematic review and individual patient data meta-analysis of randomised controlled trials. Lancet. Published 26 October 2024. doi:10.
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