Variation in hospital caesarean section rates and obstetric outcomes among nulliparae at term: a population-based cohort study

Abstract Background: Our objective was to evaluate risks of adverse obstetric outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy. Methods: We analyzed the national health insurance database, which covers almost the entire Korean population, between 2004 and 2015. The risks of adverse pregnancy outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy, compared to those in women without a diagnosed myoma, were analyzed in multivariate logistic regression analysis. Results: During the study period, 38,402 women with diagnosed myoma(s), 9,890 women with a history of myomectomy, and 740,675 women without a diagnosed myoma gave birth. Women with a history of diagnosed myoma(s) and women with a history of myomectomy had significantly higher risks of cesarean section (aOR 1.13, 95% CI 1.1-1.16 and aOR 7.46, 95% CI 6.97-7.98, respectively) and placenta previa (aOR 1.41, 95% CI 1.29-1.54 and aOR 1.58, 95% CI 1.35-1.83, respectively), compared to women without a diagnosed myoma. And the risk of uterine rupture was significantly higher in women with previous myomectomy (aOR 12.78, 95% CI 6.5-25.13), compared to women without a diagnosed myoma, which was much increased (aOR 41.35, 95% CI 16.18-105.69) in nulliparous women. The incidence of uterine rupture was the highest at delivery within one year after myomectomy and decreased over time after myomectomy. Conclusions: Women with a history of myomectomy had significantly higher risks of cesarean section and placenta previa compared to women without a diagnosed myoma.

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Late Pregnancy Vitamin D Deficiency is Associated with Doubled Odds of Birth Asphyxia and Emergency Caesarean Section: A Prospective Cohort Study

Maternal and Child Health Journal ◽

10.1007/s10995-020-02999-z ◽

2020 ◽

Vol 24 (11) ◽

pp. 1412-1418

Author(s):

Hanna Augustin ◽

Sinead Mulcahy ◽

Inez Schoenmakers ◽

Maria Bullarbo ◽

Anna Glantz ◽

...

Keyword(s):

Vitamin D ◽

Cohort Study ◽

Caesarean Section ◽

Vitamin D Deficiency ◽

Epidural Anaesthesia ◽

Birth Asphyxia ◽

Late Pregnancy ◽

Population Based ◽

Emergency Caesarean Section ◽

Vitamin D Status

Abstract Objectives The aim of this prospective cohort study was to investigate the associations between maternal vitamin D status in late pregnancy and emergency caesarean section (EMCS) and birth asphyxia, in a population based sample of women in Sweden. Methods Pregnant women were recruited at the antenatal care in Sweden and 1832 women were included after exclusion of miscarriages, terminated pregnancies and missing data on vitamin D status. Mode of delivery was retrieved from medical records. EMCS was defined as caesarean section after onset of labour. Birth asphyxia was defined as either 5 min Apgar score < 7 or arterial umbilical cord pH < 7.1. Serum was sampled in the third trimester of pregnancy (T3) and 25-hydroxyvitamin D (25OHD) was analysed by liquid chromatography tandem mass spectrometry. Vitamin D deficiency was defined as 25OHD < 30 nmol/L, and associations were studied using logistic regression analysis and expressed as adjusted odds ratios (AOR). Results In total, 141 (7.7%) women had an EMCS and 58 (3.2%) children were born with birth asphyxia. Vitamin D deficiency was only associated with higher odds of EMCS in women without epidural anaesthesia (AOR = 2.01, p = 0.044). Vitamin D deficiency was also associated with higher odds of birth asphyxia (AOR = 2.22, p = 0.044). Conclusions for Practice In this Swedish prospective population-based cohort study, vitamin D deficiency in late pregnancy was associated with doubled odds of birth asphyxia and with EMCS in deliveries not aided by epidural anaesthesia. Prevention of vitamin D deficiency among pregnant women may reduce the incidence of EMCS and birth asphyxia. The mechanism behind the findings require further investigation.

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Population-based Cohort Study of Hospital Delivery Volume, Geographic Accessibility, and Obstetric Outcomes

Obstetric Anesthesia Digest ◽

10.1097/01.aoa.0000603648.06135.a2 ◽

2019 ◽

Vol 39 (4) ◽

pp. 182-183

Author(s):

F.K. Aubrey-Bassler ◽

R.M. Cullen ◽

A. Simms ◽

S. Asghari ◽

J. Crane ◽

...

Keyword(s):

Cohort Study ◽

Population Based ◽

Obstetric Outcomes ◽

Hospital Delivery ◽

Geographic Accessibility

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Nationwide population-based cohort study of adverse obstetric outcomes in pregnancies with myoma or following myomectomy: Retrospective cohort study

10.21203/rs.3.rs-27382/v2 ◽

2020 ◽

Author(s):

Se Jin Lee ◽

Hyun Sun Ko ◽

Sunghun Na ◽

Jin Young Bae ◽

Won Joon Seong ◽

...

Keyword(s):

Cohort Study ◽

Cesarean Section ◽

Uterine Rupture ◽

Placenta Previa ◽

Multivariate Logistic Regression Analysis ◽

Population Based ◽

Obstetric Outcomes ◽

Nulliparous Women ◽

History Of ◽

Adverse Pregnancy

Abstract Background: Our objective was to evaluate risks of adverse obstetric outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy.Methods: We analyzed the national health insurance database, which covers almost the entire Korean population, between 2004 and 2015. The risks of adverse pregnancy outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy, compared to those in women without a diagnosed myoma, were analyzed in multivariate logistic regression analysis.Results: During the study period, 38,402 women with diagnosed myoma(s), 9,890 women with a history of myomectomy, and 740,675 women without a diagnosed myoma gave birth. Women with a history of diagnosed myoma(s) and women with a history of myomectomy had significantly higher risks of cesarean section (aOR 1.13, 95% CI 1.1-1.16 and aOR 7.46, 95% CI 6.97-7.98, respectively) and placenta previa (aOR 1.41, 95% CI 1.29-1.54 and aOR 1.58, 95% CI 1.35-1.83, respectively), compared to women without a diagnosed myoma. And the risk of uterine rupture was significantly higher in women with previous myomectomy (aOR 12.78, 95% CI 6.5-25.13), compared to women without a diagnosed myoma, which was much increased (aOR 41.35, 95% CI 16.18-105.69) in nulliparous women. The incidence of uterine rupture was the highest at delivery within one year after myomectomy and decreased over time after myomectomy. Conclusions: Women with a history of myomectomy had significantly higher risks of cesarean section and placenta previa compared to women without a diagnosed myoma.

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Differences in rates and odds for emergency caesarean section in six Palestinian hospitals: a population-based birth cohort study

BMJ Open ◽

10.1136/bmjopen-2017-019509 ◽

2018 ◽

Vol 8 (3) ◽

pp. e019509 ◽

Cited By ~ 7

Author(s):

Mohammed Zimmo ◽

Katariina Laine ◽

Sahar Hassan ◽

Erik Fosse ◽

Marit Lieng ◽

...

Keyword(s):

Cohort Study ◽

Caesarean Section ◽

Birth Cohort ◽

Population Based ◽

Emergency Caesarean Section ◽

Birth Cohort Study ◽

Emergency Caesarean ◽

Reference Hospital ◽

Primiparous Women ◽

Singleton Pregnancies

ObjectiveTo assess the differences in rates and odds for emergency caesarean section among singleton pregnancies in six governmental Palestinian hospitals.DesignA prospective population-based birth cohort study.SettingObstetric departments in six governmental Palestinian hospitals.Participants32 321 women scheduled to deliver vaginally from 1 March 2015 until 29 February 2016.MethodsTo assess differences in sociodemographic and antenatal obstetric characteristics by hospital, χ2test, analysis of variance and Kruskal-Wallis test were applied. Logistic regression was used to estimate differences in odds for emergency caesarean section, and ORs with 95% CIs were assessed.Main outcome measuresThe primary outcome was the adjusted ORs of emergency caesarean section among singleton pregnancies for five Palestinian hospitals as compared with the reference (Hospital 1).ResultsThe prevalence of emergency caesarean section varied across hospitals, ranging from 5.8% to 22.6% among primiparous women and between 4.8% and 13.1% among parous women. Compared with the reference hospital, the ORs for emergency caesarean section were increased in all other hospitals, crude ORs ranging from 1.95 (95% CI 1.42 to 2.67) to 4.75 (95% CI 3.49 to 6.46) among primiparous women. For parous women, these differences were less pronounced, crude ORs ranging from 1.37 (95% CI 1.13 to 1.67) to 2.99 (95% CI 2.44 to 3.65). After adjustment for potential confounders, the ORs were reduced but still statistically significant, except for one hospital among parous women.ConclusionSubstantial differences in odds for emergency caesarean section between the six Palestinian governmental hospitals were observed. These could not be explained by the studied sociodemographic or antenatal obstetric characteristics.

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Risk of retained placenta in women previously delivered by caesarean section: a population-based cohort study

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.12444 ◽

2013 ◽

Vol 121 (2) ◽

pp. 224-229 ◽

Cited By ~ 18

Author(s):

J Belachew ◽

S Cnattingius ◽

A Mulic-Lutvica ◽

K Eurenius ◽

O Axelsson ◽

...

Keyword(s):

Cohort Study ◽

Caesarean Section ◽

Population Based ◽

Retained Placenta

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Risk of uterine rupture in Australian women attempting vaginal birth after one prior caesarean section: a retrospective population-based cohort study

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.2010.02688.x ◽

2010 ◽

Vol 117 (11) ◽

pp. 1358-1365 ◽

Cited By ~ 57

Author(s):

GA Dekker ◽

A Chan ◽

CG Luke ◽

K Priest ◽

M Riley ◽

...

Keyword(s):

Cohort Study ◽

Caesarean Section ◽

Uterine Rupture ◽

Population Based ◽

Vaginal Birth

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Coronavirus and birth in Italy: results of a national population-based cohort study

10.1101/2020.06.11.20128652 ◽

2020 ◽

Author(s):

Alice Maraschini ◽

Edoardo Corsi ◽

Michele Antonio Salvatore ◽

Serena Donati ◽

Keyword(s):

Cohort Study ◽

Caesarean Section ◽

General Population ◽

Hospital Care ◽

Caesarean Section Rate ◽

National Level ◽

Population Based ◽

Decision Makers ◽

Lombardy Region ◽

National Population

AbstractIntroductionThe study was implemented to provide guidance to decision-makers and clinicians by describing hospital care offered to women who gave birth with confirmed COVID-19 infection.Materials and methodsNational population-based prospective cohort study involving all women with confirmed COVID-19 who gave birth between February 25 and April 22, 2020 in any Italian hospital.ResultsThe incidence rate of confirmed SARS-CoV-2 infection in women who gave birth was 2.1 per 1000 maternities at a national level and 6.9/1000 in the Lombardy Region. Overall one third of the women developed a pneumonia and 49.7% assumed at least one drug. Caesarean section rate was 32.9%, no mothers nor newborns died. Six percent of the infants tested positive for SARS – CoV-2 at birth.ConclusionsClinical features and outcomes of COVID-19 in women who gave birth are similar to those described for the general population, most women developing mild to moderate illness.

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