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Term cesarean delivery in the first pregnancy is not associated with an increased risk for preterm delivery in the subsequent pregnancy

Prior studies have reported an increased risk for preterm delivery following a term cesarean delivery. However, these studies did not adjust for high-risk conditions related to the first cesarean delivery and are known to recur. The objective of the study was to determine whether there is an associa...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2019-07, Vol.221 (1), p.61.e1-61.e7
Main Authors: Vahanian, Sevan A., Hoffman, Matthew K., Ananth, Cande V., Croft, Damien J., Duzyj, Christina, Fuchs, Karin M., Gyamfi-Bannerman, Cynthia, Kinzler, Wendy L., Plante, Lauren A., Ranzini, Angela C., Rosen, Todd J., Skupski, Daniel W., Smulian, John C., Vintzileos, Anthony M.
Format: Article
Language:English
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Summary:Prior studies have reported an increased risk for preterm delivery following a term cesarean delivery. However, these studies did not adjust for high-risk conditions related to the first cesarean delivery and are known to recur. The objective of the study was to determine whether there is an association between term cesarean delivery in the first pregnancy and subsequent spontaneous or indicated preterm delivery. This was a retrospective cohort study of women with the first 2 consecutive singleton deliveries (2007–2014) identified through a linked pregnancy database at a single institution. Women with a first pregnancy that resulted in cesarean delivery at term were compared with women whose first pregnancy resulted in a vaginal delivery at term. Exclusion criteria were known to recur medical or obstetrical complications during the first pregnancy. A propensity score analysis was performed by matching women who underwent a cesarean delivery with those who underwent a vaginal delivery in the first pregnancy. The association between cesarean delivery in the first pregnancy and preterm delivery in the second pregnancy in this matched set was examined using conditional logistic regression. The primary outcome was overall preterm delivery
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2019.02.036