Risk of preterm birth after prior term cesarean.

Autor: 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
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Zdroj: BJOG: An International Journal of Obstetrics & Gynaecology; Apr2020, Vol. 127 Issue 5, p610-617, 8p, 1 Diagram, 4 Charts, 1 Graph
Abstrakt: 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]
Databáze: Complementary Index
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