TY - JOUR
T1 - Risk for complications in the subsequent pregnancy following first versus second-stage cesarean delivery
T2 - 25 years follow-up in a large cohort
AU - Bitensky, Shira
AU - Pariente, Gali
AU - Rotem, Reut
AU - Sergienko, Ruslan
AU - Weintraub, Adi Yehuda
N1 - Funding Information:
This study was conducted as part of the requirements for MD degree from the Goldman Medical School at the Faculty of health sciences, Ben Gurion University of the Negev.
Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022/1/17
Y1 - 2022/1/17
N2 - Background: Cesarean delivery is a prevalent procedure worldwide, and an established risk factor for subsequent pregnancies. Aims: To examine if a prior cesarean delivery due to first vs. second stage non-progressive labor carries different risk profiles for adverse outcomes in the subsequent pregnancy. Materials and methods: A retrospective cohort study, based on data accumulated over the years 1988–2013 at the Soroka University Medical Center. We compared pregnancy complications and adverse perinatal outcomes in subsequent delivery following a cesarean delivery due to first vs. second stage non-progressive labor. Multiple logistic regression models were constructed. Results: There were 3828 subsequent deliveries of patients who underwent prior cesarean delivery due to first vs. second stage non-progressive labor, 2791 (72.91%) and 1037 (27.09%), respectively. Patients with a prior cesarean delivery due to first stage non-progressive labor were more likely to have hypertensive disorders of pregnancy (7.4% vs 3.8% in first vs. second stage non-progressive labor, respectively, p =.002), and repeated cesarean delivery at the subsequent pregnancy (70% vs 62% in first vs. second stage non-progressive labor, respectively, p <.001). Patients with prior cesarean delivery due to second stage non-progressive labor were more likely to have preterm birth (10% vs 6.8% in second vs. first stage non-progressive labor, respectively, p =.001). Prior cesarean delivery due to first stage non-progressive labor was independently associated with a recurrent cesarean delivery in the subsequent pregnancy. In addition, prior cesarean delivery due to second stage non-progressive labor was independently associated with preterm birth. Conclusions: Cesarean delivery due to first stage non-progressive labor carries higher rates of hypertensive disorders of pregnancy and recurrent cesarean delivery in the subsequent pregnancy. Prior cesarean delivery due to second stage non-progressive labor carries higher rates of subsequent preterm birth.
AB - Background: Cesarean delivery is a prevalent procedure worldwide, and an established risk factor for subsequent pregnancies. Aims: To examine if a prior cesarean delivery due to first vs. second stage non-progressive labor carries different risk profiles for adverse outcomes in the subsequent pregnancy. Materials and methods: A retrospective cohort study, based on data accumulated over the years 1988–2013 at the Soroka University Medical Center. We compared pregnancy complications and adverse perinatal outcomes in subsequent delivery following a cesarean delivery due to first vs. second stage non-progressive labor. Multiple logistic regression models were constructed. Results: There were 3828 subsequent deliveries of patients who underwent prior cesarean delivery due to first vs. second stage non-progressive labor, 2791 (72.91%) and 1037 (27.09%), respectively. Patients with a prior cesarean delivery due to first stage non-progressive labor were more likely to have hypertensive disorders of pregnancy (7.4% vs 3.8% in first vs. second stage non-progressive labor, respectively, p =.002), and repeated cesarean delivery at the subsequent pregnancy (70% vs 62% in first vs. second stage non-progressive labor, respectively, p <.001). Patients with prior cesarean delivery due to second stage non-progressive labor were more likely to have preterm birth (10% vs 6.8% in second vs. first stage non-progressive labor, respectively, p =.001). Prior cesarean delivery due to first stage non-progressive labor was independently associated with a recurrent cesarean delivery in the subsequent pregnancy. In addition, prior cesarean delivery due to second stage non-progressive labor was independently associated with preterm birth. Conclusions: Cesarean delivery due to first stage non-progressive labor carries higher rates of hypertensive disorders of pregnancy and recurrent cesarean delivery in the subsequent pregnancy. Prior cesarean delivery due to second stage non-progressive labor carries higher rates of subsequent preterm birth.
KW - First stage of labor
KW - cesarean delivery
KW - non-progressive labor
KW - second stage of labor
KW - trial of labor after cesarean
UR - http://www.scopus.com/inward/record.url?scp=85100075099&partnerID=8YFLogxK
U2 - 10.1080/14767058.2020.1852211
DO - 10.1080/14767058.2020.1852211
M3 - Article
C2 - 33455467
AN - SCOPUS:85100075099
SN - 1476-7058
VL - 35
SP - 4485
EP - 4490
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 23
ER -