How birth outcomes among a cohort of Guatemalan women with a history of prior cesarean vary by mode or birth across different interpregnancy intervals

2021 ◽  
Author(s):  
Margo Harrison ◽  
Ana Garces ◽  
Lester Figueroa ◽  
Jamie Westcott ◽  
Michael Hambidge ◽  
...  
Keyword(s):  
Mode Of Delivery ◽  
Secondary Analysis ◽  
Vaginal Birth ◽  
Global Network ◽  
Vaginal Birth After Cesarean ◽  
Cesarean Birth ◽  
Dilation And Curettage ◽  
History Of ◽  
Interpregnancy Intervals ◽  
Hospital Births

Abstract Objectives: Our objectives were to analyze how pregnancy outcomes varied by cesarean birth as compared to vaginal birth across varying interpregnancy intervals (IPI).Methods: This secondary analysis used data from a prospective registry of home and hospital births in Chimaltenango, Guatemala from January 2017 through April 2020, through the Global Network for Women’s and Children’s Health Research. Bivariate comparisons and multivariable modeling was used to answer our study question, and the data was analyzed with STATA software v.15.1.Results: Of 26,465 Guatemalan women enrolled in the registry, 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. 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.

scholarly journals How birth outcomes among a cohort of Guatemalan women with a history of prior cesarean vary by mode or birth across different interpregnancy intervals

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Margo S. Harrison ◽  
Ana Garces ◽  
Lester Figueroa ◽  
Jamie Westcott ◽  
Michael Hambidge ◽  
...  
Keyword(s):  
Mode Of Delivery ◽  
Secondary Analysis ◽  
Vaginal Birth ◽  
Global Network ◽  
Vaginal Birth After Cesarean ◽  
Cesarean Birth ◽  
Dilation And Curettage ◽  
History Of ◽  
Interpregnancy Intervals ◽  
Hospital Births

Abstract Objectives Our objectives were to analyze how pregnancy outcomes varied by cesarean birth as compared to vaginal birth across varying interpregnancy intervals (IPI) and determine if IPI modified mode of birth. Methods This secondary analysis used data from a prospective registry of home and hospital births in Chimaltenango, Guatemala from January 2017 through April 2020, through the Global Network for Women’s and Children’s Health Research. Bivariate comparisons and multivariable logistic regression were used to answer our study question, and the data was analyzed with STATA software v.15.1. Results Of 26,465 Guatemalan women enrolled in the registry, 2794 (10.6%) 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. 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, all p-values > p = 0.05. Repeat cesarean delivery, as compared to vaginal birth after cesarean, significantly reduced the likelihood a woman breastfeeding within one hour of birth (AOR ranged from 0.009 to 0.10), 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), 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.

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

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.

scholarly journals The association of timing of repeat cesarean with outcomes among a cohort of Guatemalan women with a history of prior cesarean birth

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Margo S. Harrison ◽  
Ana Garces ◽  
Lester Figueroa ◽  
Jamie Westcott ◽  
Michael Hambidge ◽  
...  
Keyword(s):  
Mode Of Delivery ◽  
Secondary Analysis ◽  
Neonatal Outcomes ◽  
Global Network ◽  
Slight Reduction ◽  
Hypertensive Disease ◽  
Cesarean Birth ◽  
Increased Risk ◽  
History Of ◽  
Using Data

Abstract Background The objective of this analysis was to observe whether maternal and perinatal/neonatal outcomes of birth vary by timing of repeat cesarean among women with a history of one prior cesarean birth in a Guatemalan cohort. Methods This secondary analysis was conducted using data from a prospective study conducted in communities in Chimaltenango, Guatemala through the Global Network for Women’s and Children’s Health Research. Results Between January 2017 and April 2020, 26,465 women delivered; 3,143 (11.9%) of those women had a singleton gestation and a history of prior cesarean delivery. 2,210 (79.9%) women with a history of prior cesarean birth had data available on mode of delivery and gave birth by repeat cesarean; 1312 (59.4%) were pre-labor cesareans while 896 (40.5%) were intrapartum cesarean births. Risk factors associated with an increased risk of intrapartum cesarean birth included hospital delivery as compared to “other” location (ARR 1.6 [1.2,2.1]) and dysfunctional labor (ARR 1.6 [1.4,1.9]). Variables associated with a reduced risk of intrapartum cesarean birth were hypertensive disease (ARR 0.7 [0.6,0.9]), schooling (ARR 0.9 [0.8,0.9]), and increasing age, which was associated with a very slight reduction in the outcome (ARR 0.99 [0.98,0.99]). Maternal and neonatal outcomes did not vary by type of cesarean birth. Conclusion Outcomes of cesarean birth do not seem to vary by timing of repeat cesarean birth, with hypertensive disease increasing the likelihood of pre-labor cesarean. This information might be useful in counseling women that outcomes after failed trial of labor do not appear worse than those after pre-labor cesarean birth.

scholarly journals The Association of Timing of Repeat Cesarean With Outcomes Among a Cohort of Guatemalan Women With a History of Prior Cesarean Birth

2021 ◽  
Author(s):  
Margo S Harrison ◽  
Ana Garces ◽  
Lester Figueroa ◽  
Jamie Westcott ◽  
Michael Hambidge ◽  
...  
Keyword(s):  
Mode Of Delivery ◽  
Secondary Analysis ◽  
Neonatal Outcomes ◽  
Global Network ◽  
Slight Reduction ◽  
Hypertensive Disease ◽  
Cesarean Birth ◽  
Increased Risk ◽  
History Of ◽  
Using Data

Abstract Background: We intended to observe whether maternal and perinatal/neonatal outcomes of birth vary by timing of repeat cesarean among women with a history of prior cesarean birth in a Guatemalan cohort. Methods: This secondary analysis was conducted using data from a prospective study conducted in communities in Chimaltenango, Guatemala through the Global Network for Women’s and Children’s Health Research.Results: Between January 2017 and April 2020, 26,465 women delivered; 3,143 (11.9%) of those women had a singleton gestation and a history of prior cesarean delivery. 2,210 (79.9%) women with a history of prior cesarean birth had data available on mode of delivery and gave birth by repeat cesarean; 1312 (59.4%) were pre-labor cesareans while 896 (40.5%) were intrapartum cesarean births. Risk factors associated with an increased risk of intrapartum cesarean birth included hospital delivery as compared to “other” location (ARR 1.6 [1.2,2.1]) and dysfunctional labor (ARR 1.6 [1.4,1.9]). Variables associated with a reduced risk of intrapartum cesarean birth were hypertensive disease (ARR 0.7 [0.6,0.9]), schooling (ARR 0.9 [0.8,0.9]), and increasing age, which was associated with a very slight reduction in the outcome (ARR 0.99 [0.98,0.99]). Maternal and neonatal outcomes did not vary by type of cesarean birth. Conclusion: Outcomes of cesarean birth do not seem to vary by timing of repeat cesarean birth, with hypertensive disease increasing the likelihood of pre-labor cesarean. This information might be useful in counseling women that outcomes after failed trial of labor do not appear worse than those after pre-labor cesarean birth.

Respiratory morbidity in twins by birth order, gestational age and mode of delivery

2016 ◽  
Vol 44 (8) ◽  
Author(s):  
Katja Bricelj ◽  
Natasa Tul ◽  
Mateja Lasic ◽  
Andreja Trojner Bregar ◽  
Ivan Verdenik ◽  
...  
Keyword(s):  
Birth Order ◽  
Cesarean Delivery ◽  
Gestational Age ◽  
Mode Of Delivery ◽  
Age Groups ◽  
Assisted Ventilation ◽  
Vaginal Birth ◽  
National Database ◽  
Respiratory Morbidity ◽  
Cesarean Birth

AbstractObjective:To evaluate the relationship between respiratory morbidity in twins by gestational age, birth order and mode of delivery.Methods:All twin deliveries at <37 weeks, registered in a national database, in the period 2003–2012 were classified into four gestational age groups: 33–36, 30–32, 28–29, and <28 weeks. Outcome variables included transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS) and need for assisted ventilation.Results:A total of 1836 twins were born vaginally, and 2142 twins were born by cesarean delivery, for a grand total of 3978 twins. TTN did not appear to be related to birth order and to the mode of delivery. In contrast, RDS was more frequent among the second born twins in the vaginal birth groups born at 30–36 weeks [odds ratio (OR) 2.5, 95% confidence interval (CI) 1.2–5.1 and OR 2.0, 95% CI 1.2–3.5 for 33–36 weeks and 30–32 weeks, respectively], whereas this trend was seen in the cesarean birth groups born earlier (OR 3.8, 95% CI 1.1–13.0 for 28–29 weeks). Cesarean delivery significantly increased the frequency of RDS in twin A as well as in twin B compared with vaginal birth, but only at gestational ages <30 weeks.Conclusion:Mode of delivery and birth order have a gestational age dependent effect on the incidence of RDS.

scholarly journals Predictors of success of trial of labor after cesarean section: A nested case–control study at public hospitals in Eastern Ethiopia

2021 ◽  
Vol 17 ◽  
pp. 174550652110619
Author(s):  
Maleda Tefera ◽  
Nega Assefa ◽  
Kedir Teji Roba ◽  
Letta Gedefa
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Vaginal Birth ◽  
Public Hospitals ◽  
Vaginal Birth After Cesarean ◽  
Eastern Ethiopia ◽  
Trial Of Labor ◽  
History Of ◽  
Nested Case Control

Background: One of the primary reasons for an increase in cesarean sections is obstetricians’ uncertainty about labor trial safety following a previous cesarean section. The success rate of vaginal birth after cesarean section with a single cesarean scar is greater than 50%. However, to the best of our knowledge, there is a scarcity of information on the determinants of vaginal birth after cesarean delivery in the study area. As a result, the purpose of this study was to identify predictors of successful vaginal birth after cesarean delivery in public hospitals in Eastern Ethiopia. Methods: A nested case–control study design was used within a prospective follow-up study conducted from June to October 2020. A total of 220 women who tried vaginal birth after cesarean delivery was included, 110 cases and 110 controls. Cases were women with one previous cesarean section scar and successfully proceed with vaginal delivery. The controls were those with an earlier cesarean section scar and delivered by emergency cesarean section after trial of labor. A pre-tested structured questionnaire was used to gather the information. Multiple logistic regression is used to identify the determinants for the success of vaginal birth after cesarean section; odds ratio with its 95% CI are used to report the findings. Results: We found that living in rural areas (AOR = 2.28; 95% CI (1.85, 12.41)), having a current antenatal care follow-up (AOR = 3.20; 95% CI (1.15, 8.87)) and partograph monitoring of labor (AOR = 4.26; 95% CI (1.90, 9.57)) had a positive association with successful vaginal birth after cesarean section. In contrast, the presence of meconium-stained amniotic liquor (AOR = 0.10; 95% CI (0.01, 0.75)) and history of stillbirth (AOR = 0.07; 95% CI (0.02, 0.53)) reducing the chance of success of the trial. Conclusion: Past obstetric history, such as stillbirth, history of labor trial after primary cesarean section, and prior vaginal birth, were significant predictors for achieving vaginal birth after cesarean section. Antenatal care visit, and partograph follow-up were the current obstetric characteristics positively associated with the trial of labor.

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