OBJECTIVE: Cesarean delivery rates are on the rise in many countries, including the United States. There is mounting evidence that cesarean delivery is associated with adverse reproductive outcomes in subsequent pregnancies. The purpose of this article is to review those outcomes in a well-defined cohort of pregnant women. STUDY DESIGN: In a cohort of primigravid women from the Danish National Birth Cohort with known baseline exposure characteristics, we stratified women by method of first delivery, vaginal or cesarean, and evaluated for appearance of adverse reproductive events in subsequent pregnancies. RESULTS: After adjusting for age, body mass index, alcohol, smoking, and socioeconomic status, women who underwent cesarean delivery at first birth were at increased risk in their subsequent pregnancy for anemia (odds ratio [OR], 2.8; 95% confidence interval [CI], 2.3-3.4), placental abruption (OR, 2.3; 95% CI, 1.5-3.6), uterine rupture (OR, 268; 95% CI, 65.6-999), and hysterectomy (OR, 28.8; 95% CI, 3.1-263.8). CONCLUSION: Women who deliver their first baby with a cesarean are at increased risk of adverse reproductive outcomes in subsequent pregnancies and should be counseled accordingly.
OBJECTIVE: Cesarean delivery rates are on the rise in many countries, including the United States. There is mounting evidence that cesarean delivery is associated with adverse reproductive outcomes in subsequent pregnancies. The purpose of this article is to review those outcomes in a well-defined cohort of pregnant women. STUDY DESIGN: In a cohort of primigravid women from the Danish National Birth Cohort with known baseline exposure characteristics, we stratified women by method of first delivery, vaginal or cesarean, and evaluated for appearance of adverse reproductive events in subsequent pregnancies. RESULTS: After adjusting for age, body mass index, alcohol, smoking, and socioeconomic status, women who underwent cesarean delivery at first birth were at increased risk in their subsequent pregnancy for anemia (odds ratio [OR], 2.8; 95% confidence interval [CI], 2.3-3.4), placental abruption (OR, 2.3; 95% CI, 1.5-3.6), uterine rupture (OR, 268; 95% CI, 65.6-999), and hysterectomy (OR, 28.8; 95% CI, 3.1-263.8). CONCLUSION:Women who deliver their first baby with a cesarean are at increased risk of adverse reproductive outcomes in subsequent pregnancies and should be counseled accordingly.
Authors: Teresa Janevic; Natalia N Egorova; Jennifer Zeitlin; Amy Balbierz; Paul L Hebert; Elizabeth A Howell Journal: Med Care Date: 2018-06 Impact factor: 2.983
Authors: Sinéad M O'Neill; Esben Agerbo; Louise C Kenny; Tine B Henriksen; Patricia M Kearney; Richard A Greene; Preben Bo Mortensen; Ali S Khashan Journal: PLoS Med Date: 2014-07-01 Impact factor: 11.069
Authors: Christopher G Fawsitt; Jane Bourke; Richard A Greene; Claire M Everard; Aileen Murphy; Jennifer E Lutomski Journal: PLoS One Date: 2013-03-06 Impact factor: 3.240
Authors: Marie Delnord; Béatrice Blondel; Nicolas Drewniak; Kari Klungsøyr; Francisco Bolumar; Ashna Mohangoo; Mika Gissler; Katarzyna Szamotulska; Nicholas Lack; Jan Nijhuis; Petr Velebil; Luule Sakkeus; James Chalmers; Jennifer Zeitlin Journal: BMC Pregnancy Childbirth Date: 2014-09-13 Impact factor: 3.007