Previous cesarean section and the risk of postpartum maternal complications and adverse neonatal outcomes in future pregnancies

• Published in: Journal of perinatology Vol. 29; no. 11; pp. 726 - 730
• Main Authors: Galyean, A M, Lagrew, D C, Bush, M C, Kurtzman, J T
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.11.2009; Nature Publishing Group
• Subjects: Aminoglycosides; Blood transfusion; Blood Transfusion - statistics & numerical data; California; Cesarean section; Cesarean Section - statistics & numerical data; Cesarean Section, Repeat - statistics & numerical data; Childbirth; Complications; Cross-Sectional Studies; Female; Health aspects; Humans; Infant, Newborn; Infant, Newborn, Diseases - epidemiology; Infant, Newborn, Diseases - etiology; Intensive Care Units - statistics & numerical data; Labor; Length of Stay - statistics & numerical data; Medicine; Medicine & Public Health; Neonates; Newborn babies; original-article; Parity; Patient Admission - statistics & numerical data; Patient outcomes; Patient Readmission - statistics & numerical data; Patients; Pediatric Surgery; Pediatrics; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postpartum; Pregnancy; Pregnancy Complications - epidemiology; Pregnancy Complications - etiology; Pregnancy Outcome; Pregnancy, Complications of; Prospective Studies; Puerperal Disorders - epidemiology; Puerperal Disorders - etiology; Puerperal Infection - epidemiology; Puerperal Infection - etiology; Retrospective Studies; Risk Assessment - statistics & numerical data; Risk factors; Thromboembolism - epidemiology; Thromboembolism - etiology; Trial of Labor; Vaginal Birth after Cesarean - statistics & numerical data; California; United States; TOL; repeat CS; risks of prior CS; elective primary CS; postpartum outcomes
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2009.108

Objective: To assess maternal postpartum and neonatal outcomes associated with previous method of delivery. Study Design: We analyzed prospectively collected maternal and neonatal data from July 2002 to December 2003. Data were collected from dedicated perinatal database and neonatal database from discharge and procedure codes. Groups were: (i) multiparous, prior vaginal delivery (VD), and (ii) multiparous, prior cesarean (CS). This group was subdivided by subsequent pregnancy trial or no trial of labor (No TOL). Results were compared with χ 2 -analysis; significance P <0.05. Results: There were 17 406 births. Prior CS patients without trial of labor (TOL) required more blood transfusions, intensive care unit admissions and hospital readmissions than women with a prior VD. Prior CS patients with TOL required more aminoglycosides for postpartum infection. Term neonates of (CS) mothers without a TOL were more likely to have prolonged hospitalization and require ventilatory support. Conclusions: In their subsequent delivery, women with a prior CS delivery are at significant risks for postpartum maternal and neonatal morbidities compared with parous patients who experienced a prior VD.