Correlation Between Previous Caesarean Section and Adverse Maternal Outcomes Accordingly With Robson Classification: Systematic Review and Meta-Analysis

• Published in: Frontiers in medicine 2022-01, Vol.8, p.740000-740000
• Main Authors: Jamshed, Shazia, Chien, Shuo-Chen, Tanweer, Afifa, Asdary, Rahma-Novita, Hardhantyo, Muhammad, Greenfield, David, Chien, Chia-Hui, Weng, Shuen-Fu, Jian, Wen-Shan, Iqbal, Usman
• Format: Article
• Language: English
• Subjects: adverse maternal outcomes; global health; Medicine; previous caesarean section; public health practice; women's health; World Health Organisation - Robson Classification
• ISSN: 2296-858X; 2296-858X
• DOI: 10.3389/fmed.2021.740000

The increasing rates of Caesarean section (CS) beyond the WHO standards (10-15%) pose a significant global health concern. Systematic review and meta-analysis to identify an association between CS history and maternal adverse outcomes for the subsequent pregnancy and delivery among women classified in Robson classification (RC). PubMed/Medline, EbscoHost, ProQuest, Embase, Web of Science, BIOSIS, MEDLINE, and Russian Science Citation Index databases were searched from 2008 to 2018. Based on Robson classification, studies reporting one or more of the 14 adverse maternal outcomes were considered eligible for this review. Study design data, interventions used, CS history, and adverse maternal outcomes were extracted. From 4,084 studies, 28 ( = 1,524,695 women) met the inclusion criteria. RC group 5 showed the highest proportion among deliveries followed by RC10, RC7, and RC8 (67.71, 32.27, 0.02, and 0.001%). Among adverse maternal outcomes, hysterectomy had the highest association after preterm delivery OR = 3.39 (95% CI 1.56-7.36), followed by Severe Maternal Outcomes OR = 2.95 (95% CI 1.00-8.67). We identified over one and a half million pregnant women, of whom the majority were found to belong to RC group 5. Previous CS was observed to be associated with adverse maternal outcomes for the subsequent pregnancies. CS rates need to be monitored given the prospective risks which may occur for maternal and child health in subsequent births.