Survey of factors influencing women’s selection of the delivery method of their second child in Shanxi Province, China

Objective: To explore the factors influencing women’s selection of the delivery method of their second child. Methods: A questionnaire survey was administered among 431 women in the age range of interest from January 2015 to January 2017, and the survey results were evaluated and analyzed statistically. The experts evaluating the questionnaire are professionals in the Department of Obstetrics and Gynecology, Heji Hospital Affiliated to Changzhi Medical College. Results: A total of 70.99% of subjects were 28-35 years old. Approximately 82.35% wished to undergo vaginal delivery, and the remaining 17.65% expressed to undergo cesarean delivery. The reasons for cesarean delivery included the following: fetal factors: worry about fetal health (33.33%), birth trauma (12.90%), and fetal macrosomia (38.17%); maternal factors: advanced age (36.56%), inability to bear uterine contraction pains (21.51%), worry about uracratia after vaginal delivery (10.75%), worry about perineum laceration (8.60%) and the impacts on sexual gratification after delivery (5.38%); social factors: faster delivery mode (54.84%), selection of birth time (27.96%), and better planning of maternity leave (17.20%). Conclusion: Most women tend to undergo vaginal delivery. However, due to the influence of age, educational level and other factors, an increasing number of women prefer cesarean delivery. Medical institutions have the responsibility for providing overall and fair medical information to women of childbearing age to help them make informed choices regarding mode of delivery. doi: https://doi.org/10.12669/pjms.37.3.2634 How to cite this:Li JQ. Survey of factors influencing women’s selection of the delivery method of their second child in Shanxi Province, China. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.2634 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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The association of interpregnancy interval and mode of delivery with outcomes among a cohort of Guatemalan women with a history of prior cesarean

10.21203/rs.3.rs-52175/v1 ◽

2020 ◽

Author(s):

Margo Harrison ◽

Ana Garces ◽

Lester Figueroa ◽

Jamie Westcott ◽

Michael Hambidge ◽

...

Keyword(s):

Cesarean Delivery ◽

Mode Of Delivery ◽

Vaginal Birth ◽

Delivery Mode ◽

Interpregnancy Interval ◽

Vaginal Birth After Cesarean ◽

Cesarean Birth ◽

Dilation And Curettage ◽

History Of ◽

Repeat Cesarean Delivery

Abstract Design: Our objectives were to analyze how interpregnancy interval (IPI) was associated with delivery mode and how outcomes varied by these characteristics.Methods: This secondary analysis used data from a prospective study conducted in Chimaltenango, Guatemala from January 2017 through April 2020.Results: Of 26,465 Guatemalan women, 3,170 (12.0%) had a history of prior cesarean. 560 (20.1%) women delivered by vaginal birth after cesarean with the remaining 2,233 (79.9%) delivered by repeat cesarean delivery. Repeat cesarean reduced the risk of needing a dilation and curettage compared to vaginal birth after cesarean, but this association did not vary by IPI (AOR 0.01 – 0.03, p < 0.001). Repeat cesarean delivery, as compared to vaginal birth after cesarean, significantly reduced the likelihood a woman breastfeeding within one hour of birth (AOR 0.009 – 0.10, p < 0.001), but IPI was not associated with the outcome. Regarding stillbirth, repeat cesarean birth reduced the likelihood of stillbirth as compared to vaginal birth (AOR 0.2, p = 0.001 – 0.002), but again IPI was not associated with the outcome.Conclusion: Outcomes by mode of delivery among a Guatemalan cohort of women with a history of prior cesarean birth do not vary by IPI.

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Indicators for mode of delivery in pregnant women with uteruses scarred by prior caesarean section: a retrospective study of 679 pregnant women

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2604-0 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Zhifen Hua ◽

Fadwa El Oualja

Keyword(s):

Retrospective Study ◽

Caesarean Section ◽

Pregnant Women ◽

Vaginal Delivery ◽

Gestational Age ◽

Placenta Previa ◽

Mode Of Delivery ◽

Fetal Membrane ◽

Delivery Mode ◽

Maternal Preference

Abstract Background The delivery mode for pregnant women with uteruses scarred by prior caesarean section (CS) is a controversial issue, even though the CS rate has risen in the past 20 years. We performed this retrospective study to identify the factors associated with preference for CS or vaginal birth after CS (VBAC). Methods Pregnant women (n = 679) with scarred uteruses from Moulay Ali Cherif Provincial Hospital, Rashidiya, Morocco, were enrolled. Gestational age, comorbidity, fetal position, gravidity and parity, abnormal amniotic fluid, macrosomia, placenta previa or abruptio, abnormal fetal presentation, premature rupture of fetal membrane with labor failure, poor progression in delivery, and fetal outcomes were recorded. Results Out of 679 pregnant women ≥28 gestational weeks, 351 (51.69%) had a preference for CS. Pregnant women showed preference for CS if they were older (95% CI 1.010–1.097), had higher gestational age (95% CI 1.024–1.286), and a shorter period had passed since the last CS (95% CI 0.842–0.992). Prior gravidity (95% CI 0.638–1.166), parity (95% CI 0.453–1.235), vaginal delivery history (95% CI 0.717–1.818), and birth weight (95% CI 1.000–1.001) did not influence CS preference. In comparison with fetal preference, maternal preference was the prior indicator for CS. Correlation analysis showed that pregnant women with longer intervals since the last CS and history of gravidity, parity, and vaginal delivery showed good progress in the first and second stages of vaginal delivery. Conclusions We concluded that maternal and gestational age and interval since the last CS promoted CS preference among pregnant women with scarred uteruses.

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Comparison of Melatonin Levels in the Colostrum between Vaginal Delivery and Cesarean Delivery

American Journal of Perinatology ◽

10.1055/s-0037-1608681 ◽

2017 ◽

Vol 35 (05) ◽

pp. 481-485 ◽

Cited By ~ 1

Author(s):

Ziya Kalem ◽

Tuncay Yuce ◽

Batuhan Bakırarar ◽

Feride Söylemez ◽

Müberra Namlı Kalem

Keyword(s):

Cesarean Section ◽

Cesarean Delivery ◽

Vaginal Delivery ◽

Mode Of Delivery ◽

Elective Cesarean Section ◽

Enzyme Linked Immunosorbent Assay ◽

Cross Sectional ◽

Emergency Cesarean ◽

Study Results ◽

Elective Cesarean

Objective This study aims to compare melatonin levels in colostrum between vaginal and cesarean delivery. Study Design This cross-sectional study was conducted with 139 mothers who gave live births between February 2016 and December 2016. The mothers were divided into three groups according to the mode of delivery: 60 mothers (43.2%) in the vaginal delivery group, 47 mothers (33.8%) in the elective cesarean delivery, and 32 mothers (23.0%) in the emergency cesarean delivery group. Colostrum of the mothers was taken between 01:00 and 03:00 a.m. within 48 to 72 hours following the delivery, and the melatonin levels were measured using the enzyme-linked immunosorbent assay (ELISA) and compared between the groups. Results The melatonin levels in the colostrum were the highest in the vaginal delivery group, lower in the elective cesarean section group, and the lowest in the emergency cesarean group (265.7 ± 74.3, 204.9 ± 55.6, and 167.1 ± 48.1, respectively; p < 0.001). The melatonin levels in the colostrum did not differ according to the demographic characteristics of the mothers, gestational age, birth weight, newborn sex, the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores, and for the requirement for neonatal intensive care. Conclusion Our study results showed that melatonin levels in the colostrum of the mothers who delivered vaginally were higher than those who delivered by cesarean section. Considering the known benefits of melatonin for the newborns, we believe that vaginal delivery poses an advantage.

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Influence of severity of total bile acids and mode of delivery on the perinatal outcomes in intrahepatic cholestasis of pregnancy

10.21203/rs.3.rs-267237/v1 ◽

2021 ◽

Author(s):

Chengcai Kong ◽

Fenglin Mei ◽

Pingping Xue ◽

Jingyun Cao ◽

Yong Li ◽

...

Keyword(s):

Bile Acids ◽

Cesarean Delivery ◽

Vaginal Delivery ◽

Intrahepatic Cholestasis ◽

Mode Of Delivery ◽

Intrahepatic Cholestasis Of Pregnancy ◽

Fetal Outcomes ◽

Increased Risk ◽

Total Bile Acids ◽

Cholestasis Of Pregnancy

Abstract To assess the associations between mode of delivery and pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy (ICP) based on the severity of maternal hypercholanemia. A hospital-based retrospective cohort study was performed between January 1, 2015, and December 31, 2019. Among the 177 women with mild total bile acids, 123 (69.5%) had a vaginal delivery and 54 (30.5%) underwent a cesarean delivery, of which 42 (23.7%) were planned and 12 (6.8%) were unplanned. Among the 50 severe ICP women, 13 (26.0%) had a vaginal delivery and 37 (74.0%) underwent a cesarean delivery, of which 26 (52.0%) were planned and 11 (22.0%) were unplanned. Severe ICP was associated with an increased risk of preterm delivery (P < 0.001), low birthweight (P=0.001), and neonatal intensive care unit admission (P < 0.001). Women with severe ICP (aOR, 5.017; 95% CI 1.848–13.622), planned cesarean delivery (aOR, 5.444; 95%CI 1.723–17.203), or unplanned cesarean delivery (aOR, 5.792; 95%CI 1.384–24.236) had increased risks of adverse fetal outcomes compared to controls. Both planned and unplanned cesarean delivery are associated with a higher incidence of adverse fetal outcomes and severe ICP than vaginal delivery.

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The impact of delivery mode on the risk of neonatal intracranial haemorrhage

Slovenian Nursing Review ◽

10.14528/snr.2019.53.3.751 ◽

2019 ◽

Vol 53 (3) ◽

Author(s):

Nika Buh ◽

Miha Lučovnik

Keyword(s):

Vaginal Delivery ◽

Intracranial Haemorrhage ◽

Caesarean Delivery ◽

Mode Of Delivery ◽

Vacuum Extraction ◽

Delivery Mode ◽

Spontaneous Vaginal Delivery ◽

Emergency Caesarean ◽

Vaginal Deliveries ◽

The Impact

Introduction: The objective of the study was to examine the association between the mode of delivery and the incidence of neonatal intracranial haemorrhage.Methods: Slovenian National Perinatal Information System (NPIS) data for the period 2002 through 2016 were analysed. Nulliparous women delivering singleton neonates in cephalic presentation weighting 2,500 to 4,000g were included. Incidence of neonatal intracranial haemorrhage in vacuum delivery vs. other modes of delivery was compared using the Chi-square test (p < 0.05 significant).Results: 125,393 deliveries were included: 5,438 (4 %) planned caesarean deliveries, 9,7764 (78 %) spontaneous vaginal deliveries, 15,577 (12 %) emergency caesarean deliveries, and 6,614 (5 %) vacuum extractions. 17 (0.14/1000) neonatal intracranial haemorrhages were recorded: 12 occurred in spontaneous vaginal deliveries, two in emergency caesarean deliveries, and three in vacuum extractions. In comparison to infants born by spontaneous vaginal delivery, those delivered by vacuum extraction had higher rates of intracranial haemorrhage (odds ratio (OR) 3.70; 95% confidence interval (CI) 1.04−13.10). Risk estimates did not reach statistical significance when comparing infants born by vacuum extraction and those born by emergency caesarean delivery (OR 3.54; 95% CI 0.59−21.16).Discussion and conclusion: Infants born by vacuum extraction have significantly higher rates of intracranial haemorrhage than those born by spontaneous vaginal delivery although the absolute risk is small. There are no significant differences in the rates of intracranial haemorrhage in vacuum extraction vs. emergency caesarean delivery.

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A Prospective Investigation of Cesarean Birth with Total and Truncal Fat Mass in Early Adolescence

Current Developments in Nutrition ◽

10.1093/cdn/nzaa054_111 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1039-1039

Author(s):

Lidia Minguez Alarcon ◽

Sheryl Rifas-Shiman ◽

Joanne Sordillo ◽

Izzuddin Aris ◽

Marie-France Hivert ◽

...

Keyword(s):

Cesarean Delivery ◽

Vaginal Delivery ◽

Fat Mass ◽

Early Adolescence ◽

Maternal Age ◽

The United States ◽

Delivery Mode ◽

Linear Regression Models ◽

Funding Sources ◽

The Difference

Abstract Objectives Nearly 1.3 million cesarean deliveries are performed each year in the United States, resulting in the birth of one third of all children nationwide. A higher risk of childhood obesity has been observed among children born by cesarean, but this literature is inconsistent. We investigated differences in total and truncal fat mass during early adolescence among offspring born by cesarean compared to those born by vaginal delivery. Methods This prospective study includes adolescents (median age 12.8 years) whose mothers enrolled in while pregnant in Project Viva between 1999 and 2002, and who have been followed since birth. A total of 740 adolescents had available total and truncal fat mass measured using Dual Energy X-Ray Absorptiometry (DXA) at the early adolescent in-person visit. We abstracted delivery mode from electronic medical records. We used multivariable linear regression models to estimate the difference in total and truncal fat mass indices (FMI, kg/m,2) among adolescents born by cesarean compared to those born by vaginal delivery while adjusting for confounders. We used stabilized inverse probability weights to account for censoring. Results Mean (SD) maternal age was 32.2 (5.4) years and pre-pregnancy BMI was 25.0 (5.3) kg/m,2. A total of 157 (21%) of the adolescents were born by cesarean delivery and 51%were female; mean (SD) total and truncal FMI were 6.3 (3.1) and 2.4 (1.5) kg/m,2 respectively. Adolescents born by cesarean vs. vaginal delivery had significantly higher total [β (95% CI) = 0.78 (0.23, 1.33) kg/m,2] and truncal [β (95% CI) = 0.35 (0.08, 0.61) kg/m,2] FMI than those born by vaginal delivery in models adjusted for child age and sex, and maternal age, education and race/ethnicity. These associations were attenuated and no longer statistically significant after further adjusting for maternal pre-pregnancy BMI [β (95% CI) = 0.45 (−0.06, 0.96) kg/m,2 for total and 0.19 (−0.05, 0.44) kg/m,2 for truncal FMI]. Additional adjustment for gestational weight gain, smoking and paternal BMI did not substantially change the results. Conclusions These data suggest that the association between birth by cesarean delivery and adolescent adiposity is largely explained by maternal pre-pregnancy BMI. Funding Sources NIH grants R01HD093761, R01HD034568, R01ES024765, and UH3 OD023286.

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Cesarean delivery among women with prolonged labor induction

Journal of Perinatal Medicine ◽

10.1515/jpm-2014-0357 ◽

2016 ◽

Vol 44 (7) ◽

Cited By ~ 3

Author(s):

Louise L. Highley ◽

Rebecca A. Previs ◽

Sarah K. Dotters-Katz ◽

Leo R. Brancazio ◽

Chad A. Grotegut

Keyword(s):

Cesarean Delivery ◽

Vaginal Delivery ◽

Mode Of Delivery ◽

Labor Induction ◽

University Hospital ◽

Delivery Rate ◽

Multivariate Logistic Regression Model ◽

Nulliparous Women ◽

Prolonged Labor ◽

Cesarean Delivery Rate

AbstractObjective:The objective of this study was to determine characteristics associated with cesarean delivery among women with labor induction lasting over 24 h.Study design:Women with live singleton pregnancies without prior cesarean delivery undergoing a labor induction lasting >24 h between September 2006 and March 2009 at Duke University Hospital were identified. Collected variables were compared between subjects by mode of delivery. A multivariate logistic regression model for the outcome cesarean delivery was constructed separately for nulliparous and parous women.Results:There were 303 women who met inclusion criteria. The overall cesarean delivery rate was 57% (n=172) and remained constant with time (P=0.15, test-for-trend). Nulliparous women having a cesarean delivery were more likely to be obese [adjusted OR (aOR) 2.00; 95% CI 1.05, 3.80] and have a larger fetus [aOR 1.11 (aOR for every 100 g increase in birthweight), 95% CI 1.03, 1.20] compared to those having a vaginal delivery.Conclusion:Increasing BMI and birthweight were independent predictors of cesarean delivery among nulliparous women with prolonged labor induction. Despite this, after 24 h of labor induction, the overall mean cesarean delivery rate remained constant at 57%, and did not change with time. Among women having a vaginal delivery following a prolonged labor induction, we saw high rates of shoulder dystocia, operative vaginal delivery and severe perineal laceration.

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The Association Between Mode of Delivery and Later Educational Outcomes

International Journal for Population Data Science ◽

10.23889/ijpds.v5i5.1472 ◽

2020 ◽

Vol 5 (5) ◽

Author(s):

Eileen Li ◽

Rebecca Slykerman ◽

Barry Milne

Keyword(s):

New Zealand ◽

Secondary School ◽

Gut Microbiota ◽

Vaginal Delivery ◽

Educational Outcomes ◽

Educational Achievement ◽

Mode Of Delivery ◽

Delivery Mode ◽

Developmental Problems ◽

The Impact

IntroductionCaesarean section (C-section) is becoming increasingly prevalent worldwide. It can be a life-saving intervention when medical complications arise, but may cause adverse consequences for the mothers when it is not medically necessary. The upwards trend of C-section is becoming a general concern as it might be associated with a wide range of child outcomes such as immune diseases, respiratory diseases and developmental problems. One underlying mechanism of such association is through gut microbiota. Mode of delivery is a signification factor which determines the gut bacterial environment in early days of life. Gut microbiota can impact cognitive development via microbiota gut brain axis. Objectives and ApproachThis study investigated the association between mode of delivery and later educational outcomes of the children, using linked data from New Zealand Integrated Data Infrastructure. The participants consisted of children born in New Zealand between 1Jan1996 and 31Dec1998. All birth information were retrieved from Department of Internal Affairs and were linked to Ministry of Health data to obtain delivery methods from mothers’ diagnosis records. Once delivery modes were identified, the data was then linked to records from Ministry of Education to obtain children’s educational outcomes at secondary school. Three outcome variables were chosen: University Entrance, Highest Endorsement Level and National Certificate of Educational Achievement Level 2 Percentile Score. ResultsThe results have shown that C-section and assisted vaginal delivery were associated with better secondary school educational achievement, comparing to unassisted vaginal delivery. The results persisted after adjusting for sociodemographic factors such as household income, maternal education and deprivation index; infant factors such as birth weight, gestational age and ethnicity. However, when within family variation was further controlled for in the sibling fixed effects analysis, C-section was no longer associated with improved educational achievement. Conclusion / ImplicationsThis indicated that the impact of delivery mode might be negligible on later educational achievement.

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The Impact of Race on Postpartum Opioid Prescribing Practices: A Retrospective Cohort Study

10.21203/rs.3.rs-73638/v1 ◽

2020 ◽

Author(s):

Tyler Ryan McKinnish ◽

Adam K. Lewkowitz ◽

Ebony B. Carter ◽

Ashley E. Veade

Keyword(s):

Cesarean Delivery ◽

Vaginal Delivery ◽

White Women ◽

Private Insurance ◽

Mode Of Delivery ◽

Sensitivity Analyses ◽

Wound Complications ◽

Fourth Degree ◽

Black And White ◽

The Impact

Abstract BackgroundTo identify the association between inpatient postpartum opioid consumption, race, and amount of opioids prescribed at discharge after vaginal or cesarean delivery. MethodsA total of 416 women who were prescribed an oral opioid following vaginal or cesarean delivery at a single tertiary academic institution between July 2018 and October 2018 were identified. Women with postoperative wound complications, third and fourth degree lacerations, cesarean hysterectomy, or a history of opioid abuse were excluded. The primary outcome was the number of oxycodone 5 mg tablets prescribed at discharge, stratified by race and mode of delivery. Only “Black” and “White” women were included in analyses due to low absolute numbers of other identities. Black women were compared to white women using multivariable logistic regression. Multiple sensitivity analyses were performed.ResultsThe median number of oxycodone tablets consumed during hospitalization following cesarean delivery was seven (IQR: 2.5–12 tablets) and following vaginal delivery was one (IQR: 0-3). White women were more likely to be older at delivery regardless of route (median 32 vs. 30 years for cesarean delivery, and 29 vs. 27 years for vaginal delivery; p<0.01 for both). White women undergoing cesarean delivery did so at a lower maternal BMI (31.6 vs. 34.5; p=0.02). White women were also significantly more likely to have private insurance and to experience perineal lacerations following vaginal delivery. The number of inpatient opioid tablets consumed, as well as the number prescribed at discharge, were not statistically different between Black and White women, regardless of mode of delivery. These findings persisted in sensitivity analyses.ConclusionAt our large, academic hospital the number of tablets prescribed at discharge had no association with patient race or inpatient usage regardless of mode of delivery.

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Global Changes of 5-mC/5h-mC Ratio and Methylation of Adiponectin and Leptin Gene in Placenta Depending on Mode of Delivery

International Journal of Molecular Sciences ◽

10.3390/ijms22063195 ◽

2021 ◽

Vol 22 (6) ◽

pp. 3195

Author(s):

Aneta Słabuszewska-Jóźwiak ◽

Marcelina Malinowska ◽

Anna Kloska ◽

Joanna Jakóbkiewicz-Banecka ◽

Mariusz Gujski ◽

...

Keyword(s):

Dna Methylation ◽

Vaginal Delivery ◽

Mode Of Delivery ◽

Elective Cesarean Section ◽

Global Changes ◽

Delivery Mode ◽

Cesarean Sections ◽

Global Methylation ◽

Vaginal Deliveries ◽

Elective Cesarean

It was suggested that the epigenetic alterations of the placenta are associated with obesity, as well as the delivery mode. This study aimed to assess the effect of maternal outcome and delivery procedure on global placental DNA methylation status, as well as selected 5’-Cytosine-phosphate-Guanine-3’ (CpG) sites in ADIPOQ and LEP genes. Global DNA methylation profile in the placenta was assessed using the 5-methylcytosine (5-mC) and 5-hydroxymethylcytosine (5-hmC) ratio evaluated with the ELISA, followed by target gene methylation patterns at selected gene regions which were determined using methylation-specific qPCR in 70 placentas from healthy, pregnant women with single pregnancy. We found no statistically significant differences in 5-mC/5-hmC ratio between intrapartum cesarean sections (CS) and vaginal deliveries (p = 0.214), as well as between elective cesarean sections and vaginal deliveries (p = 0.221). In intrapartum cesarean sections, the ADIPOQ demethylation index was significantly higher (the average: 1.75) compared to elective cesarean section (the average: 1.23, p = 0.010) and vaginal deliveries (the average: 1.23, p = 0.011). The LEP demethylation index did not significantly differ among elective CS, intrapartum CS, and vaginal delivery groups. The demethylation index of ADIPOQ correlated negatively with LEP in the placenta in the vaginal delivery group (r = −0.456, p = 0.017), but not with the global methylation. The methylation of a singular locus might be different depending on the mode of delivery and uterine contractions. Further studies should be conducted with locus-specific analysis of the whole genome to detect the methylation index of specific genes involved in metabolism.

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