Risk of preterm birth after prior term cesarean.
BJOG
; 127(5): 610-617, 2020 Apr.
Article
in En
| MEDLINE
| ID: mdl-31883402
ABSTRACT
OBJECTIVE:
To determine the risk of overall preterm birth (PTB) and spontaneous PTB in a pregnancy after a caesarean section (CS) at term.DESIGN:
Longitudinal linked national cohort study.SETTING:
The Dutch Perinatal Registry (1999-2009). POPULATION 268 495 women with two subsequent singleton pregnancies were identified.METHODS:
A cohort study based on linked registered data from two subsequent pregnancies in the Netherlands. MAIN OUTCOMEMEASURES:
The incidence of overall PTB and spontaneous PTB with subgroup analysis on gestational age at first delivery and type of CS (planned or unplanned).RESULTS:
Of 268 495 women with a singleton first pregnancy who delivered at term, 15.76% (n = 42 328) had a CS. The incidence of PTB in the second pregnancy was 2.79% (n = 1182) in women with a previous CS versus 2.46% (n = 5570) in women with a previous vaginal delivery (adjusted odds ratio [aOR] 1.14, 95% confidence interval [CI] 1.07-1.21). This increased risk is mainly driven by an increased risk of spontaneous PTB after previous CS at term (aOR 1.50, 95% CI 1.38-1.70). Analysis for type of CS compared with vaginal delivery showed an aOR on spontaneous PTB of 1.86 (95% CI 1.58-2.18) for planned CS and an aOR of 1.40 (95% CI 1.24-1.58) for unplanned CS.CONCLUSIONS:
CS at term is associated with a marginally increased risk of spontaneous PTB in a subsequent pregnancy. TWEETABLE ABSTRACT Caesarean section at term is associated with a marginally increased risk of spontaneous PTB in a subsequent pregnancy.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Cesarean Section
/
Premature Birth
/
Term Birth
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Country/Region as subject:
Europa
Language:
En
Year:
2020
Type:
Article