Caesarean section and subsequent pregnancy outcome: a Danish register-based cohort study

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dc.contributor.advisor Agerbo, Esben en
dc.contributor.advisor Kenny, Louise C. en
dc.contributor.advisor Greene, Richard A. en
dc.contributor.advisor Kearney, Patricia M. en
dc.contributor.advisor Khashan, Ali S. en
dc.contributor.author O'Neill, Sinéad M. en
dc.date.accessioned 2015-02-05T17:19:25Z
dc.date.available 2016-02-06T05:00:06Z
dc.date.issued 2014
dc.date.submitted 2014
dc.identifier.citation O'Neill, S. M. 2014. Caesarean section and subsequent pregnancy outcome: a Danish register-based cohort study. PhD Thesis, University College Cork. en
dc.identifier.endpage 292
dc.identifier.uri http://hdl.handle.net/10468/1776
dc.description.abstract Background and Aims: Caesarean section rates have increased in recent decades and the effects on subsequent pregnancy outcome are largely unknown. Prior research has hypothesised that Caesarean section delivery may lead to an increased risk of subsequent stillbirth, miscarriage, ectopic pregnancy and sub-fertility. Structure and Methods: Papers 1-3 are systematic reviews with meta-analyses. Papers 4-6 are findings from this thesis on the rate of subsequent stillbirth, miscarriage, ectopic pregnancy and live birth by mode of delivery. Results Systematic reviews and meta-analyses: A 23% increased odds of subsequent stillbirth; no increase in odds of subsequent ectopic pregnancy and a 10% reduction in the odds of subsequent live birth among women with a previous Caesarean section were found in the various meta-analyses. Danish cohorts: Results from the Danish Civil Registration System (CRS) cohort revealed a small increased rate of subsequent stillbirth and ectopic pregnancy among women with a primary Caesarean section, which remained in the analyses by type of Caesarean. No increased rate of miscarriage was found among women with a primary Caesarean section. In the CRS data, women with a primary Caesarean section had a significantly reduced rate of subsequent live birth particularly among women with primary elective and maternal-requested Caesarean sections. In the Aarhus Birth Cohort, overall the effect of mode of delivery on the rate and time to next live birth was minimal. Conclusions: Primary Caesarean section was associated with a small increased rate of stillbirth and ectopic pregnancy, which may be in part due to underlying medical conditions. No increased rate of miscarriage was found. A reduced rate of subsequent live birth was found among Caesarean section in the CRS data. In the smaller ABC cohort, a small reduction in rate of subsequent live birth was found among women with a primary Caesarean section and is most likely due to maternal choice rather than any ill effects of the Caesarean. The findings of this study, the largest and most comprehensive to date will be of significant interest to health care providers and women globally. en
dc.description.sponsorship Health Research Board (PhD Scholars programme in Health Services Research, Grant No.PHD/2007/16) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher University College Cork en
dc.rights © 2014, Sinéad M. O'Neill en
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/3.0/ en
dc.subject Caesarean section en
dc.subject Mode of delivery en
dc.subject Stillbirth en
dc.subject Miscarriage en
dc.subject Ectopic pregnancy en
dc.subject Cox regression en
dc.subject Subfertility en
dc.subject Danish registry data en
dc.subject Cohort study en
dc.title Caesarean section and subsequent pregnancy outcome: a Danish register-based cohort study en
dc.type Doctoral thesis en
dc.type.qualificationlevel Doctoral Degree (Structured) en
dc.type.qualificationname PhD (Health Services Research) en
dc.internal.availability Full text available en
dc.check.info Please note that Chapter 6 (pp. 184-203) is unavailable due to a restriction requested by the author. en
dc.description.version Accepted Version
dc.contributor.funder National Perinatal Epidemiology Centre, College of Medicine and Health, University College Cork en
dc.contributor.funder Health Research Board en
dc.description.status Not peer reviewed en
dc.internal.school Epidemiology and Public Health en
dc.internal.school Obstetrics and Gynaecology en
dc.check.reason This thesis is due for publication or the author is actively seeking to publish this material en
dc.check.opt-out Not applicable en
dc.thesis.opt-out false
dc.check.chapterOfThesis 6
dc.check.embargoformat E-thesis on CORA only en
ucc.workflow.supervisor a.khashan@ucc.ie
dc.internal.conferring Autumn Conferring 2014


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© 2014, Sinéad M. O'Neill Except where otherwise noted, this item's license is described as © 2014, Sinéad M. O'Neill
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