Elective repeat cesarean delivery compared with trial of labor after a prior cesarean delivery: A propensity score analysis

N. Kok, L. Ruiter, R. Lindeboom, C. De Groot, E. Pajkrt, B. W. Mol, B. M. Kazemier

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective To determine neonatal and short term maternal outcomes according to intentional mode of delivery following a cesarean delivery (CD). Study design Women pregnant after CD between January 2000 and December 2007 were categorized according to whether they had an elective repeat CD (ERCD) or a Trial of Labor (TOL). Prognostically equal ERCD and TOL groups were created using the propensity score matching technique. Conditional logistic regression was performed to assess differences in neonatal and maternal outcomes. Population Women in their second ongoing pregnancy with a history of CD. Results After ERCD the rates of low 5 min Apgar score (OR 0.3, 95%CI 0.2-0.5, p < 0.001), meconium aspiration (OR 0.0, 95%CI 0-0.7, p = 0.02) and birth trauma (OR 0.08, 95%CI 0.002-0.5, p < 0.001) were lower compared to TOL. The rate of transient tachypnoea of the newborn (TTN) appears higher in the ERCD group (OR 1.7, 95%CI 1.0-2.8, p = 0.04). Uterine rupture (OR 0.1, 95%CI 0.003-0.8, p = 0.02) and hemorrhage (OR 0.6, 95%CI 0.5-0.8, p < 0.001) occurred less in the ERCD group. Conclusion Neonatal and short term maternal morbidity appears to be lower after ERCD than after TOL. Only TTN was seen more often after ERCD.

LanguageEnglish
Pages214-218
Number of pages5
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Volume195
DOIs
Publication statusPublished - 1 Dec 2015

Keywords

  • Adverse neonatal outcomes
  • Elective repeat cesarean delivery (ERCD)
  • Propensity score matching
  • Trial of labor (TOL)
  • Vaginal birth after cesarean delivery (VBAC)

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

Cite this

Kok, N. ; Ruiter, L. ; Lindeboom, R. ; De Groot, C. ; Pajkrt, E. ; Mol, B. W. ; Kazemier, B. M. / Elective repeat cesarean delivery compared with trial of labor after a prior cesarean delivery : A propensity score analysis. In: European Journal of Obstetrics and Gynecology and Reproductive Biology. 2015 ; Vol. 195. pp. 214-218.
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Elective repeat cesarean delivery compared with trial of labor after a prior cesarean delivery : A propensity score analysis. / Kok, N.; Ruiter, L.; Lindeboom, R.; De Groot, C.; Pajkrt, E.; Mol, B. W.; Kazemier, B. M.

In: European Journal of Obstetrics and Gynecology and Reproductive Biology, Vol. 195, 01.12.2015, p. 214-218.

Research output: Contribution to journalArticle

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T2 - European Journal of Obstetrics Gynecology and Reproductive Biology

AU - Kok, N.

AU - Ruiter, L.

AU - Lindeboom, R.

AU - De Groot, C.

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AU - Mol, B. W.

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N2 - Objective To determine neonatal and short term maternal outcomes according to intentional mode of delivery following a cesarean delivery (CD). Study design Women pregnant after CD between January 2000 and December 2007 were categorized according to whether they had an elective repeat CD (ERCD) or a Trial of Labor (TOL). Prognostically equal ERCD and TOL groups were created using the propensity score matching technique. Conditional logistic regression was performed to assess differences in neonatal and maternal outcomes. Population Women in their second ongoing pregnancy with a history of CD. Results After ERCD the rates of low 5 min Apgar score (OR 0.3, 95%CI 0.2-0.5, p < 0.001), meconium aspiration (OR 0.0, 95%CI 0-0.7, p = 0.02) and birth trauma (OR 0.08, 95%CI 0.002-0.5, p < 0.001) were lower compared to TOL. The rate of transient tachypnoea of the newborn (TTN) appears higher in the ERCD group (OR 1.7, 95%CI 1.0-2.8, p = 0.04). Uterine rupture (OR 0.1, 95%CI 0.003-0.8, p = 0.02) and hemorrhage (OR 0.6, 95%CI 0.5-0.8, p < 0.001) occurred less in the ERCD group. Conclusion Neonatal and short term maternal morbidity appears to be lower after ERCD than after TOL. Only TTN was seen more often after ERCD.

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