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- Title
Risk of preterm birth after prior term cesarean.
- 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
- Abstract
<bold>Objective: </bold>To determine the risk of overall preterm birth (PTB) and spontaneous PTB in a pregnancy after a caesarean section (CS) at term.<bold>Design: </bold>Longitudinal linked national cohort study.<bold>Setting: </bold>The Dutch Perinatal Registry (1999-2009).<bold>Population: </bold>268 495 women with two subsequent singleton pregnancies were identified.<bold>Methods: </bold>A cohort study based on linked registered data from two subsequent pregnancies in the Netherlands.<bold>Main Outcome Measures: </bold>The incidence of overall PTB and spontaneous PTB with subgroup analysis on gestational age at first delivery and type of CS (planned or unplanned).<bold>Results: </bold>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.<bold>Conclusions: </bold>CS at term is associated with a marginally increased risk of spontaneous PTB in a subsequent pregnancy.<bold>Tweetable Abstract: </bold>Caesarean section at term is associated with a marginally increased risk of spontaneous PTB in a subsequent pregnancy.
- Subjects
NETHERLANDS; 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
- Publication
BJOG: An International Journal of Obstetrics & Gynaecology, 2020, Vol 127, Issue 5, p610
- ISSN
1470-0328
- Publication type
journal article
- DOI
10.1111/1471-0528.16083