Helena Litorp1, Mattias Rööst2, Hussein L Kidanto3, Lennarth Nyström4, Birgitta Essén2. 1. International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. Electronic address: helena.litorp@kbh.uu.se. 2. International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. 3. International Maternal and Child Health (IMCH), Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Obstetrics and Gynaecology, Muhimbili National Hospital, Dar es Salaam, Tanzania. 4. Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.
Abstract
OBJECTIVE: To investigate if multiparous individuals who had undergone a previous cesarean delivery experienced an increased risk of severe maternal outcomes or adverse perinatal outcomes compared with multiparous individuals who had undergone previous vaginal deliveries. METHODS: An analytical cross-sectional study at a university hospital in Dar es Salaam, Tanzania, enrolled multiparous participants of at least 28weeks of pregnancy between February 1 and June 30, 2012 . Data were collected from patients' medical records and the hospital's obstetric database. Odds ratios (OR) and 95% confidence intervals (CI) were calculated to compare outcomes among patients who had or had not undergone previous cesarean deliveries. RESULTS: A total of 2478 patients were enrolled. A previous cesarean delivery resulted in no increase in the risk of severe maternal outcomes (OR 0.86, 95% CI 0.58-1.26; P=0.46), and decreased risk of stillbirth (OR 0.42, 95% CI 0.29-0.62, P<0.001), and intrapartum stillbirth and neonatal distress (OR 0.58, 95% CI 0.38-0.87, P=0.007). CONCLUSION: Previous cesarean delivery was not a risk factor for severe maternal outcomes or adverse perinatal outcomes. The present study was conducted at a referral institution, where individuals with previous cesarean deliveries may constitute a healthy group. Additionally, there could be differences between the study groups in terms of healthcare-seeking behavior, referral mechanisms, intrapartum monitoring, and clinical decision making.
OBJECTIVE: To investigate if multiparous individuals who had undergone a previous cesarean delivery experienced an increased risk of severe maternal outcomes or adverse perinatal outcomes compared with multiparous individuals who had undergone previous vaginal deliveries. METHODS: An analytical cross-sectional study at a university hospital in Dar es Salaam, Tanzania, enrolled multiparous participants of at least 28weeks of pregnancy between February 1 and June 30, 2012 . Data were collected from patients' medical records and the hospital's obstetric database. Odds ratios (OR) and 95% confidence intervals (CI) were calculated to compare outcomes among patients who had or had not undergone previous cesarean deliveries. RESULTS: A total of 2478 patients were enrolled. A previous cesarean delivery resulted in no increase in the risk of severe maternal outcomes (OR 0.86, 95% CI 0.58-1.26; P=0.46), and decreased risk of stillbirth (OR 0.42, 95% CI 0.29-0.62, P<0.001), and intrapartum stillbirth and neonatal distress (OR 0.58, 95% CI 0.38-0.87, P=0.007). CONCLUSION: Previous cesarean delivery was not a risk factor for severe maternal outcomes or adverse perinatal outcomes. The present study was conducted at a referral institution, where individuals with previous cesarean deliveries may constitute a healthy group. Additionally, there could be differences between the study groups in terms of healthcare-seeking behavior, referral mechanisms, intrapartum monitoring, and clinical decision making.
Authors: Rosa Maria Soares Madeira Domingues; Marcos Augusto Bastos Dias; Arthur Orlando Corrêa Schilithz; Maria do Carmo Leal Journal: Reprod Health Date: 2016-10-17 Impact factor: 3.223