Risk of preterm birth after prior term cesarean.
- Resource Type
- journal article
- Authors
- Visser, L; Slaager, C; Kazemier, BM; Rietveld, AL; Oudijk, MA; Groot, CJM; Mol, BW; Boer, MA; Kazemier, B M; Rietveld, A L; Oudijk, M A; de Groot, Cjm; Mol, B W; de Boer, M A
- Source
- BJOG: An International Journal of Obstetrics & Gynaecology. Apr2020, Vol. 127 Issue 5, p610-617. 8p. 1 Diagram, 4 Charts, 1 Graph.
- Subject
- *PREMATURE labor
*CESAREAN section
*ODDS ratio
*GESTATIONAL age
*PREGNANCY
*RELATIVE medical risk
*PREMATURE infants
*DURATION of pregnancy
*ACQUISITION of data
*DISEASE incidence
*DELIVERY (Obstetrics)
*LONGITUDINAL method
- Language
- ISSN
- 1470-0328
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 Outcome Measures: 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. [ABSTRACT FROM AUTHOR]