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Full dilatation caesarean section and the risk of preterm delivery in a subsequent pregnancy : a historical cohort study

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Ewington, Lauren Jade and Quenby, Siobhan (2020) Full dilatation caesarean section and the risk of preterm delivery in a subsequent pregnancy : a historical cohort study. Journal of Clinical Medicine, 9 (12). 3998. doi:10.3390/jcm9123998

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Official URL: http://dx.doi.org/10.3390/jcm9123998

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Abstract

Full dilatation caesarean sections (CS) have increased risk of uterine extensions, which leads to cervical trauma that has been associated with an increased risk of spontaneous preterm birth (sPTB) in a subsequent pregnancy. The aim of this study was to determine if CS at full dilatation increased the risk of sPTB in a subsequent pregnancy in our unit. A historical cohort study was performed on women delivered by emergency CS between 2008–2015 (n = 5808) in a university hospital who had a subsequent pregnancy in this time frame (n = 1557). Women were classified into two exposure groups; those who were 6–9 cm and those fully dilated at index CS. The reference group was CS at 0–5 cm dilated. The primary outcome was sPTB < 37 weeks’ gestation. CS at 6–9 cm or fully dilated did not significantly increase the odds of sPTB in a subsequent pregnancy (aOR 1.64, 95% CI: 0.83–3.28, p = 0.158; aOR 1.86, 95% CI: 0.91–3.83; p = 0.090, respectively). However, a short interpregnancy interval of <1 year significantly increased the odds of sPTB in a subsequent pregnancy (aOR 3.10, 95% CI: 1.71–5.61). This study has found a short interpregnancy interval following a CS conferred a higher risk of sPTB than full dilatation CS. This finding highlights postnatal contraception and increased surveillance of women with short interpregnancy interval post CS as possible interventions to reduce sPTB.

Item Type: Journal Article
Subjects: R Medicine > RG Gynecology and obstetrics
R Medicine > RJ Pediatrics
Divisions: Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Cell & Developmental Biology
Faculty of Medicine > Warwick Medical School > Biomedical Sciences
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Cesarean section , Cesarean section -- Complications, Premature infants, Labor (Obstetrics) -- Complications, Premature labor
Journal or Publication Title: Journal of Clinical Medicine
Publisher: Royal College of Physicians
ISSN: 2077-0383
Official Date: 10 December 2020
Dates:
DateEvent
10 December 2020Published
8 December 2020Accepted
Date of first compliant deposit: 15 December 2020
Volume: 9
Number: 12
Article Number: 3998
DOI: 10.3390/jcm9123998
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access

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