History of CD does not increase risk for PTL

  • Am J Obsyet Gynecol

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Cesarean delivery (CD) does not increase risk for preterm labor (PTL) in a subsequent pregnancy.

Why this matters

  • The rates of CD are rising.
  • Some studies suggest a link between history of CD and subsequent preterm delivery.
  • Women can be counseled that in the absence of risk factors, CD does not increase the risk for preterm labor in a subsequent pregnancy.

Key results

  • Mean age at delivery of a second baby was similar:
    • CD:
      • mean age at delivery, 38.8 weeks;
      • aOR, 1.46 (95% CI, 0.77-2.76);
    • Vaginal delivery:
      • mean age at delivery, 38.9 weeks;
      • aOR, 1.40 (95% CI, 0.59-3.32).

Study design

  • Retrospective cohort study.
  • Women with first 2 consecutive singleton, low-risk pregnancies were identified through a database.
  • A propensity score prediction model for term CD in the first pregnancy was developed; propensity score analysis used to match patients.
  • Women with a CD in the first pregnancy (n=1142) compared with women with a vaginal delivery (n=1142) in the first pregnancy.
  • The primary outcome was preterm delivery (
  • Funding: None disclosed.

Limitations

  • Many participants excluded in the process of matching the cohort groups.

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