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Table 2 Association between previous caesarean delivery and maternal outcomes in the subsequent pregnancy

From: Association between first caesarean delivery and adverse outcomes in subsequent pregnancy: a retrospective cohort study

Maternal outcomes

previous SVD(n = 6240)

previous CS(n = 5422)

Crude OR1 (95% CI)

Model 1 Adjusted OR1 (95% CI)

previous nonindicated CS(n = 1827)

Crude OR2 (95% CI)

Model 2 Adjusted OR2 (95% CI)

N

%

N

%

  

N

%

  

PIH

99

1.6%

131

2.4%

1.54 (1.18–2.00)

1.38 (1.04–1.82)a

75

4.1%

2.66 (1.96–3.60)

2.20 (1.59–3.05)d

PE

84

1.3%

90

1.7%

1.24 (0.92–1.67)

1.22 (0.88–1.69)a

34

1.9%

1.39 (0.93–2.08)

1.24 (0.79–1.94)d

GDM

705

11.3%

736

13.6%

1.23 (1.10–1.38)

1.15 (1.02–1.29)a

371

20.3%

2.00 (1.74–2.30)

1.82 (1.57–2.11)d

Gestational anaemia

455

7.3%

458

8.4%

1.17 (1.03–1.34)

1.13 (0.98–1.30)

166

9.1%

1.27 (1.06–1.53)

1.27 (1.05–1.55)d

Gestational thyroid disease

256

4.1%

223

4.1%

1.01 (0.84–1.20)

1.03 (0.85–1.24)

64

3.5%

0.85 (0.64–1.12)

0.86 (0.65–1.16)d

ICP

29

0.5%

43

0.8%

1.71 (1.07–2.75)

1.72 (1.04–2.84)

14

0.8%

1.65 (0.87–3.14)

1.65 (0.84–3.23)d

PROM

1217

19.5%

445

8.2%

0.37 (0.33–0.41)

0.34 (0.30–0.39)

140

7.7%

0.34 (0.29–0.41)

0.32 (0.26–0.39)d

fetal distress

493

7.9%

159

2.9%

0.35 (0.29–0.42)

0.33 (0.27–0.40)

55

3.0%

0.36 (0.27–0.48)

0.34 (0.25–0.46)d

meconium-staining of the amniotic fluid

 I degree

58

0.9%

50

0.9%

0.91 (0.62–1.33)

0.94 (0.63–1.40)

17

0.9%

0.91 (0.53–1.57)

0.97 (0.56–1.70)d

 II degree

236

3.8%

114

2.1%

0.51 (0.41–0.64)

0.49 (0.39–0.62)

33

1.8%

0.44 (0.30–0.63)

0.39 (0.26–0.57)d

 III degree

472

7.6%

67

1.2%

0.15 (0.12–0.19)

0.15 (0.11–0.19)

17

0.9%

0.11 (0.07–0.18)

0.11 (0.07–0.18)d

AFV

 Oligohydramnios

65

1.0%

67

1.2%

1.20 (0.85–1.69)

1.15 (0.81–1.64)

25

1.4%

1.33 (0.84–2.12)

1.37 (0.85–2.21)d

 Polyhydramnios

39

0.6%

82

1.5%

2.45 (1.67–3.59)

2.50 (1.69–3.69)

27

1.5%

2.39 (1.46–3.92)

2.60 (1.57–4.31)d

Placental abruption

19

0.3%

7

0.1%

0.42 (0.18–1.01)

0.51 (0.21–1.25)

4

0.2%

0.72 (0.24–2.11)

0.92 (0.30–2.80)d

Placenta previa

66

1.1%

124

2.3%

2.19 (1.62–2.96)

2.11 (1.52–2.94)

62

3.4%

3.29 (2.31–4.67)

3.18 (2.15–4.71)d

Placenta accreta

53

0.8%

104

1.9%

2.28 (1.64–3.18)

2.11 (1.47–3.04)

45

2.5%

2.95 (1.97–4.40)

2.75 (1.75–4.31)d

Rupture of uterus

0

0.0%

7

0.1%

/

/

4

0.2%

/

/

APH

61

1.0%

59

1.1%

1.11 (0.78–1.60)

0.96 (0.64–1.43)

25

1.4%

1.41 (0.88–2.25)

1.13 (0.66–1.93)d

FGR

82

1.3%

70

1.3%

0.98 (0.71–1.35)

0.93 (0.65–1.33)

22

1.2%

0.92 (0.57–1.47)

0.89 (0.53–1.51)d

Abnormal fetal position

193

3.1%

194

3.6%

1.16 (0.95–1.42)

1.09 (0.88–1.35)

47

2.6%

0.83 (0.60–1.14)

0.77 (0.55–1.09)d

Dystocia

197

3.2%

196

3.6%

1.15 (0.94–1.41)

1.09 (0.88–1.34)

46

2.5%

0.79 (0.57–1.10)

0.73 (0.52–1.04)d

Antepartum fever

55

0.9%

27

0.5%

0.56 (0.36–0.89)

0.54 (0.33–0.89)

9

0.5%

0.56 (0.28–1.13)

0.60 (0.29–1.24)d

Mode of delivery

 Caesarean section

823

13.2%

5278

97.3%

263.28 (217.98–318.01)

364.21 (294.74–450.06)b

1795

98.2%

375.49 (261.30–539.58)

694.16 (468.45–1028.62)e

 Instrumental delivery

80

1.3%

14

0.3%

7.18 (3.97–13.01)

8.30 (4.41–15.60)b

1

0.1%

2.15 (0.29–15.96)

6.40 (0.84–48.80)e

PPH

119

1.9%

107

2.0%

1.04 (0.80–1.35)

0.69 (0.42–1.14)c

43

2.4%

1.24 (0.87–1.76)

0.54 (0.30–0.97)f

Puerperal infection

16

0.3%

15

0.3%

1.08 (0.53–2.19)

0.99 (0.35–2.83)c

4

0.2%

0.85 (0.29–2.56)

0.50 (0.12–2.19)f

  1. SVD spontaneous vaginal delivery, CS caesarean section, PIH pregnancy-induced hypertension, PE preeclampsia, GDM gestational diabetes mellitus, ICP intrahepatic cholestasis of pregnancy, PROM prelabour rupture of membranes, AFV amniotic fluid volume, APH antepartum haemorrhage, PPH postpartum haemorrhage, FGR fetal growth restriction, OR odds radio, CI confidence interval
  2. Model 1: all ORs adjusted for birth place, insurance, age at the second delivery, height, maternal BMI, educational level, gravidity, interpregnancy interval
  3. aORs further adjusted for PIH, PE and GDM in first birth
  4. bORs further adjusted for PIH, GDM, ICP, gestational anaemia, PROM and meconium-staining of the amniotic fluid, AFV, fetal distress, placental abruption, placenta previa, placenta accreta, rupture of uterus and antepartum fever
  5. cORs further adjusted for PIH, GDM, ICP, gestational anaemia, PROM and meconium-staining of the amniotic fluid, AFV, fetal distress, placental abruption, placenta previa, placenta accreta, rupture of uterus, antepartum fever and mode of delivery
  6. Model 2: all ORs adjusted for insurance, marital status, age at the second delivery, height, maternal BMI, educational level, gravidity, interpregnancy interval
  7. dORs further adjusted for PIH, PE and GDM in first birth
  8. eORs further adjusted for PIH, GDM, gestational anaemia, PROM, meconium-staining of the amniotic fluid, AFV, fetal distress, placenta previa, placenta accreta, rupture of uterus
  9. fORs further adjusted for PIH, GDM, gestational anaemia, PROM and meconium-staining of the amniotic fluid, AFV, fetal distress, placenta previa, placenta accreta, rupture of uterus and mode of delivery