Planned mode of delivery after previous cesarean section and short-term maternal and perinatal outcomes: A population-based record linkage cohort study in Scotland

English version

Autoři: Kathryn E. Fitzpatrick ^aff001; Jennifer J. Kurinczuk ^aff001; Sohinee Bhattacharya ^aff002; Maria A. Quigley ^aff001
Působiště autorů: National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom ^aff001; The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom ^aff002
Vyšlo v časopise: Planned mode of delivery after previous cesarean section and short-term maternal and perinatal outcomes: A population-based record linkage cohort study in Scotland. PLoS Med 16(9): e1002913. doi:10.1371/journal.pmed.1002913
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1002913

Souhrn

Background

Policy consensus in high-income countries supports offering pregnant women with previous cesarean section a choice between planning an elective repeat cesarean section (ERCS) or attempting a vaginal birth, known as a planned vaginal birth after previous cesarean (VBAC), provided they do not have contraindications to planned VBAC. However, robust comprehensive information on the associated outcomes to counsel eligible women about this choice is lacking. This study investigated the short-term maternal and perinatal outcomes associated with planned mode of delivery after previous cesarean section among women delivering a term singleton and considered eligible to have a planned VBAC.

Methods and findings

A population-based cohort of 74,043 term singleton births in Scotland between 2002 and 2015 to women with one or more previous cesarean sections was conducted using linked Scottish national datasets. Logistic or modified Poisson regression, as appropriate, was used to estimate the effect of planned mode of delivery on maternal and perinatal outcomes adjusted for sociodemographic, maternal medical, and obstetric-related characteristics. A total of 45,579 women gave birth by ERCS, and 28,464 had a planned VBAC, 28.4% of whom went on to have an in-labor nonelective repeat cesarean section. Compared to women delivering by ERCS, those who had a planned VBAC were significantly more likely to have uterine rupture (0.24%, n = 69 versus 0.04%, n = 17, adjusted odds ratio [aOR] 7.3, 95% confidence interval [CI] 3.9–13.9, p < 0.001), a blood transfusion (1.14%, n = 324 versus 0.50%, n = 226, aOR 2.3, 95% CI 1.9–2.8, p < 0.001), puerperal sepsis (0.27%, n = 76 versus 0.17%, n = 78, aOR 1.8, 95% CI 1.3–2.7, p = 0.002), and surgical injury (0.17% versus 0.09%, n = 40, aOR 3.0, 95% CI 1.8–4.8, p < 0.001) and experience adverse perinatal outcomes including perinatal death, admission to a neonatal unit, resuscitation requiring drugs and/or intubation, and an Apgar score < 7 at 5 minutes (7.99%, n = 2,049 versus 6.37%, n = 2,570, aOR 1.6, 95% CI 1.5–1.7, p < 0.001). However, women who had a planned VBAC were more likely than those delivering by ERCS to breastfeed at birth or hospital discharge (63.6%, n = 14,906 versus 54.5%, n = 21,403, adjusted risk ratio [aRR] 1.2, 95% CI 1.1–1.2, p < 0.001) and were more likely to breastfeed at 6–8 weeks postpartum (43.6%, n = 10,496 versus 34.5%, n = 13,556, aRR 1.2, 95% CI 1.2–1.3, p < 0.001). The effect of planned mode of delivery on the mother’s risk of having a postnatal stay greater than 5 days, an overnight readmission to hospital within 42 days of birth, and other puerperal infection varied according to whether she had any prior vaginal deliveries and, in the case of length of postnatal stay, also varied according to the number of prior cesarean sections. The study is mainly limited by the potential for residual confounding and misclassification bias.

Conclusions

Among women considered eligible to have a planned VBAC, planned VBAC compared to ERCS is associated with an increased risk of the mother having serious birth-related maternal and perinatal complications. Conversely, planned VBAC is associated with an increased likelihood of breastfeeding, whereas the effect on other maternal outcomes differs according to whether a woman has any prior vaginal deliveries and the number of prior cesarean sections she has had. However, the absolute risk of adverse outcomes is small for either delivery approach. This information can be used to counsel and manage the increasing number of women with previous cesarean section, but more research is needed on longer-term outcomes.

Klíčová slova:

Neonates – Hospitals – Birth – Labor and delivery – Stillbirths – Cesarean section – Scotland

Zdroje

1. Thomas J, Paranjothy S; Royal College of Obstetricians and Gynaecologists Clinical Effectiveness Support Unit. National Sentinel Caesarean Section Audit Report. London: RCOG Press; 2001.

2. Flamm BL. Cesarean section: a worldwide epidemic? Birth. 2000;27(2):139–40. 11251493.

3. Declercq E, Young R, Cabral H, Ecker J. Is a rising cesarean delivery rate inevitable? Trends in industrialized countries, 1987 to 2007. Birth. 2011;38(2):99–104. doi: 10.1111/j.1523-536X.2010.00459.x 21599731.

4. Betran AP, Ye J, Moller AB, Zhang J, Gulmezoglu AM, Torloni MR. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990–2014. PLoS ONE. 2016;11(2):e0148343. Epub 2016/02/06. doi: 10.1371/journal.pone.0148343 26849801; PubMed Central PMCID: PMC4743929.

5. NHS Digital. NHS Maternity Statistics, England 2016–17. 2017.

6. Information Services Division Scotland. Births in Scottish Hospitals Year ending 31 March 2017. Edinburgh: Information Services Division Scotland; 2017.

7. Welsh Government. Maternity Statistics Wales, 2015–16. 2017.

8. Royal College of Obstetricians and Gynaecologists. Birth After Previous Caesarean Birth, Green-top Guideline No. 45. London: Royal College of Obstetricians and Gynaecologists; 2015.

9. National Institute for Health and Clinical Excellence. Caesarean section NICE clinical guideline 132. 2011.

10. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 205: Vaginal Birth After Cesarean Delivery. Obstet Gynecol 2019;133(2).

11. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Birth after previous caesarean section. Melbourne: The Royal Australian and New Zealand College of Obstetricians and Gynaecologists; 2015.

12. Healthtalkonline. Making decisions about birth after caesarean. October 2007 [cited 2017 Aug 14]. Available from: http://www.healthtalk.org/peoples-experiences/pregnancy-children/making-decisions-about-birth-after-caesarean/overview.

13. Emmett CL, Shaw AR, Montgomery AA, Murphy DJ, Di Asg. Women's experience of decision making about mode of delivery after a previous caesarean section: the role of health professionals and information about health risks. BJOG. 2006;113(12):1438–45. doi: 10.1111/j.1471-0528.2006.01112.x 17081180.

14. Black M, Entwistle VA, Bhattacharya S, Gillies K. Vaginal birth after caesarean section: why is uptake so low? Insights from a meta-ethnographic synthesis of women's accounts of their birth choices. BMJ Open. 2016;6(1):e008881. doi: 10.1136/bmjopen-2015-008881 26747030; PubMed Central PMCID: PMC4716170.

15. Lundgren I, Begley C, Gross MM, Bondas T. 'Groping through the fog': a metasynthesis of women's experiences on VBAC (Vaginal birth after Caesarean section). BMC Pregnancy Childbirth. 2012;12:85. doi: 10.1186/1471-2393-12-85 22909230; PubMed Central PMCID: PMC3506503.

16. Guise J-M, Eden K, Emeis C, Denman MA, Marshall N, Fu RR, et al. Vaginal birth after cesarean: new insights. Evidence report/technology assessment. 2010;(191):1–397. 20629481

17. National Records of Scotland. Quality of Data Obtained from the Registration of Births, Stillbirths, Marriages, Civil Partnerships and Deaths. Available from: https://www.nrscotland.gov.uk/files//statistics/vital-events/quality-data-obtained-from-registration-of-ve.pdf. [cited 2018 May 16].

18. Information Services Division Scotland. Births in Scottish Hospitals Technical Report Publication date—28 November 2017. Edinburgh: Information Services Division Scotland; 2017.

19. Information Services Division Scotland. Data Quality Assurance Assessment of Maternity Data (SMR02) 2008–2009. Edinburgh: Information Services Division Scotland; 2010.

20. Information Services Division Scotland. Assessment of SMR01 Data 2010–2011. Edinburgh: Information Services Division Scotland; 2012.

21. Healthcare Improvement Scotland. Scottish Perinatal and Infant Mortality and Morbidity Report 2010. Edinburgh: Healthcare Improvement Scotland; 2012.

22. Information Services Division Scotland. Infant Feeding Statistics Scotland Publication date—31 October 2017. Edinburgh: Information Services Division Scotland; 2017.

23. Royal College of Obstetricians and Gynaecologists. Late Intrauterine Fetal Death and Stillbirth Green-top Guidelines No. 55. London: Royal College of Obstetricians and Gynaecologists; 2010.

24. Knol MJ, Le Cessie S, Algra A, Vandenbroucke JP, Groenwold RH. Overestimation of risk ratios by odds ratios in trials and cohort studies: alternatives to logistic regression. Cmaj. 2012;184(8):895–9. doi: 10.1503/cmaj.101715 22158397

25. van Smeden M, de Groot JA, Moons KG, Collins GS, Altman DG, Eijkemans MJ, et al. No rationale for 1 variable per 10 events criterion for binary logistic regression analysis. BMC Med Res Methodol 2016;16:163. doi: 10.1186/s12874-016-0267-3 27881078

26. Vittinghoff E, McCulloch CE. Relaxing the Rule of Ten Events per Variable in Logistic and Cox Regression. American Journal of Epidemiology. 2007;165(6):710–8. doi: 10.1093/aje/kwk052 17182981

27. Landon MB, Hauth JC, Leveno KJ, Spong CY, Leindecker S, Varner MW, et al. Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. N Engl J Med. 2004;351(25):2581–9. doi: 10.1056/NEJMoa040405 15598960.

28. Fitzpatrick KE, Kurinczuk JJ, Alfirevic Z, Spark P, Brocklehurst P, Knight M. Uterine rupture by intended mode of delivery in the UK: a national case-control study. PLoS Med. 2012;9(3):e1001184. doi: 10.1371/journal.pmed.1001184 22427745

29. Gregory KD, Korst LM, Fridman M, Shihady I, Broussard P, Fink A, et al. Vaginal birth after cesarean: clinical risk factors associated with adverse outcome. Am J Obstet Gynecol. 2008;198(4):452 e1-10; discussion e10-2. Epub 2008/04/09. doi: 10.1016/j.ajog.2008.01.008 18395037.

30. Royston P, Ambler G, Sauerbrei W. The use of fractional polynomials to model continuous risk variables in epidemiology. Int J Epidemiol. 1999;28(5):964–74. Epub 1999/12/22. oi: 10.1093/ije/28.5.964. doi: 10.1093/ije/28.5.964 10597998.

31. White IR, Royston P, Wood AM. Multiple imputation using chained equations: Issues and guidance for practice. Statistics in Medicine. 2009;30:377–99.

32. Bartlett JW, Seaman SR, White IR, Carpenter JR. Multiple imputation of covariates by fully conditional specification: Accommodating the substantive model. Statistical Methods in Medical Research. 2014;24:462–87. doi: 10.1177/0962280214521348 24525487

33. Bonellie S, Chalmers J, Gray R, Greer I, Jarvis S, Williams C. Centile charts for birthweight for gestational age for Scottish singleton births. BMC Pregnancy Childbirth. 2008;8:5. Epub 2008/02/27. doi: 10.1186/1471-2393-8-5 18298810; PubMed Central PMCID: PMC2268653.

34. Guise JM, McDonagh MS, Osterweil P, Nygren P, Chan BK, M. H. Systematic review of the incidence and consequences of uterine rupture in women with previous caesarean section. BMJ. 2004;329:19–25. doi: 10.1136/bmj.329.7456.19 15231616

35. Dekker GA, Chan A, Luke CG, Priest K, Riley M, Halliday J, et al. Risk of uterine rupture in Australian women attempting vaginal birth after one prior caesarean section: a retrospective population-based cohort study. BJOG. 2010;117(11):1358–65. doi: 10.1111/j.1471-0528.2010.02688.x 20716251

36. Kok N, Ruiter L, Lindeboom R, de Groot C, Pajkrt E, Mol BW, et al. Elective repeat cesarean delivery compared with trial of labor after a prior cesarean delivery: a propensity score analysis. European journal of obstetrics, gynecology, and reproductive biology. 2015;195:214–8. doi: 10.1016/j.ejogrb.2015.09.011 26599733

37. Crowther CA, Dodd JM, Hiller JE, Haslam RR, Robinson JS. Planned vaginal birth or elective repeat caesarean: Patient preference restricted cohort with nested randomised trial. PLoS Med. 2012;9(3):e1001192. doi: 10.1371/journal.pmed.1001192 22427749

38. Shatz L, Novack L, Mazor M, Weisel RB, Dukler D, Rafaeli-Yehudai T, et al. Induction of labor after a prior cesarean delivery: lessons from a population-based study. Journal of perinatal medicine. 2013;41(2):171–9. doi: 10.1515/jpm-2012-0103 23095188

39. Bickford CD, Janssen PA. Maternal and newborn outcomes after a prior cesarean birth by planned mode of delivery and history of prior vaginal birth in British Columbia: a retrospective cohort study. CMAJ open. 2015;3(2):E158–65. doi: 10.9778/cmajo.20140055 26389093

40. Miller ES, Grobman WA. Obstetric outcomes associated with induction of labor after 2 prior cesarean deliveries. American journal of obstetrics and gynecology. 2015;213(1):89.e1-5. doi: 10.1016/j.ajog.2015.02.003 25683964

41. Nair M, Soffer K, Noor N, Knight M, Griffiths M. Selected maternal morbidities in women with a prior caesarean delivery planning vaginal birth or elective repeat caesarean section: a retrospective cohort analysis using data from the UK Obstetric Surveillance System. BMJ open. 2015;5(6):e007434. doi: 10.1136/bmjopen-2014-007434 26038358

42. Colmorn LB, Krebs L, Klungsoyr K, Jakobsson M, Tapper A-M, Gissler M, et al. Mode of first delivery and severe maternal complications in the subsequent pregnancy. Acta obstetricia et gynecologica Scandinavica. 2017.

43. Cahill AG, Tuuli M, Odibo AO, Stamilio DM, MacOnes GA. Vaginal birth after caesarean for women with three or more prior caesareans: Assessing safety and success. BJOG: An International Journal of Obstetrics and Gynaecology. 2010;117(4):422–7.

44. Holm C, Langhoff-Roos J, Petersen KB, Norgaard A, Diness BR. Severe postpartum haemorrhage and mode of delivery: a retrospective cohort study. BJOG. 2012;119(5):596–604. doi: 10.1111/j.1471-0528.2011.03267.x 22313728

45. Stattmiller S, Lavecchia M, Czuzoj-Shulman N, Spence AR, Abenhaim HA. Trial of labor after cesarean in the low-risk obstetric population: a retrospective nationwide cohort study. Journal of perinatology. 2016;36(10):808–13. doi: 10.1038/jp.2016.36 27253892

46. Cahill AG, Stamilio DM, Odibo AO, Peipert JF, Ratcliffe SJ, Stevens EJ, et al. Is vaginal birth after cesarean (VBAC) or elective repeat cesarean safer in women with a prior vaginal delivery? Am J Obstet Gynecol. 2006;195(4):1143–7. doi: 10.1016/j.ajog.2006.06.045 16846571

47. Mercer BM, Gilbert S, Landon MB, Spong CY, Leveno KJ, Rouse DJ, et al. Labor outcomes with increasing number of prior vaginal births after cesarean delivery. Obstet Gynecol. 2008;111(2):285–91.

48. Tahseen S, Griffiths M. Vaginal birth after two caesarean sections (VBAC-2)-a systematic review with meta-analysis of success rate and adverse outcomes of VBAC-2 versus VBAC-1 and repeat (third) caesarean sections. BJOG. 2010;117(1):5–19. doi: 10.1111/j.1471-0528.2009.02351.x 19781046.

49. Regan J, Thompson A, DeFranco E. The influence of mode of delivery on breastfeeding initiation in women with a prior cesarean delivery: a population-based study. Breastfeeding medicine: the official journal of the Academy of Breastfeeding Medicine. 2013;8:181–6.

50. Wallenborn JT, Graves WC, Masho SW. Breastfeeding Initiation in Mothers with Repeat Cesarean Section: The Impact of Marital Status. Breastfeeding medicine: the official journal of the Academy of Breastfeeding Medicine. 2017;12(4):227–32.

51. Bjellmo S, Andersen GL, Martinussen MP, Romundstad PR, Hjelle S, Moster D, et al. Is vaginal breech delivery associated with higher risk for perinatal death and cerebral palsy compared with vaginal cephalic birth? Registry-based cohort study in Norway. BMJ Open. 2017;7(4):e014979. doi: 10.1136/bmjopen-2016-014979 28473516

52. Herbst A. Term breech delivery in Sweden: mortality relative to fetal presentation and planned mode of delivery. Acta Obstet Gynecol Scand. 2005;84(6):593–601. doi: 10.1111/j.0001-6349.2005.00852.x 15901273

53. Smith GC, Pell JP, Cameron AD, Dobbie R. Risk of perinatal death associated with labor after previous cesarean delivery in uncomplicated term pregnancies. JAMA. 2002;287(20):2684–90. doi: 10.1001/jama.287.20.2684 12020304

54. Litwin CE, Czuzoj-Shulman N, Zakhari A, Abenhaim HA. Neonatal outcomes following a trial of labor after Caesarean delivery: a population-based study. The journal of maternal-fetal & neonatal medicine. 2018;31(16):2148–2154.

55. Wen S, Guo Y, Xie R, Dy J, Walker M. Secular trends in trial of labor and associated neonatal mortality and morbidity in the United States, 1995 to 2002. Zhong nan da xue xue bao Yi xue ban = Journal of Central South University Medical sciences. 2012;37(11):1088–96. doi: 10.3969/j.issn.1672-7347.2012.11.002 23202616

56. Gilbert SA, Grobman WA, Landon MB, Spong CY, Rouse DJ, Leveno KJ, et al. Elective repeat cesarean delivery compared with spontaneous trial of labor after a prior cesarean delivery: a propensity score analysis. American journal of obstetrics and gynecology. 2012;206(4):311.e1-9. doi: 10.1016/j.ajog.2012.02.002 22464069

57. Rossi AC, Prefumo F. Pregnancy outcomes of induced labor in women with previous cesarean section: a systematic review and meta-analysis. Arch Gynecol Obstet. 2015;291(2):273–80. doi: 10.1007/s00404-014-3444-9 25178187.

58. Nguyen CD, Carlin JB, Lee KJ. Model checking in multiple imputation: an overview and case study. Emerg Themes Epidemiol. 2017;14:8. doi: 10.1186/s12982-017-0062-6 28852415; PubMed Central PMCID: PMC5569512.