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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
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 | ||||||
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| Subjects: | R Medicine > RG Gynecology and obstetrics R Medicine > RJ Pediatrics |
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| 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 |
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| 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: |
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| 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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