Trial of labour after caesarean section and the risk of neonatal and infant death: a nationwide cohort study

Simple item page
dc.contributor.authorO'Neill, Sinéad M.
dc.contributor.authorAgerbo, Esben
dc.contributor.authorKhashan, Ali S.
dc.contributor.authorKearney, Patricia M.
dc.contributor.authorHenriksen, Tine B.
dc.contributor.authorGreene, Richard A.
dc.contributor.authorKenny, Louise C.
dc.contributor.funderHealth Research Boarden
dc.contributor.funderScience Foundation Irelanden
dc.date.accessioned2017-03-24T11:30:45Z
dc.date.available2017-03-24T11:30:45Z
dc.date.issued2017-02-27
dc.date.updated2017-03-24T10:17:38Z
dc.description.abstractBackground: Caesarean section (CS) rates are increasing worldwide and as a result repeat CS is common. The optimal mode of delivery in women with one previous CS is widely debated and the risks to the infant are understudied. The aim of the current study was to evaluate if women with a trial of labour after caesarean (TOLAC) had an increased odds of neonatal and infant death compared to women with an elective repeat CS (ERCS). Methods: A population register-based cohort study was conducted in Denmark between 1982 and 2010. All women with two deliveries [in which the first was a CS, and the second was an uncomplicated, term delivery (n = 61,626)] were included in the study. Logistic regression models were used to report adjusted odds ratios (AOR) and 95% confidence intervals (CI) of the odds of death according to mode of delivery. The main outcome measures were neonatal death (early and late) and infant death. Results: Women with a TOLAC had an increased odds of neonatal death (AOR 1 · 87, 95% CI 1 · 12 to 3 · 12) due to an increased risk of early neonatal death (AOR 2 · 06, 95% CI 1 · 19 to 3 · 56) and no effect on late neonatal death (AOR 0 · 97, 95% CI 0 · 22 to 4 · 32), or infant death (AOR 1 · 12, 95% CI 0 · 79 to 1 · 59) when compared to the reference group of women with an ERCS. There was evidence of a cohort effect as the increased odds of neonatal death (AOR 3 · 89, 95% CI 1 · 33 to 11 · 39) was most significant in the earlier years (1982–1991) and gradually disappeared (AOR 1 · 01, 95% CI 0 · 44 to 2 · 31) in the later years (2002–2010). Conclusions: Although an increased risk of neonatal death was found in women with a TOLAC, there was evidence of a cohort effect, which showed this increased odds disappearing over time. Advances in modern healthcare including improved monitoring and earlier detection of underlying pregnancy complications may explain the findings.en
dc.description.sponsorshipHealth Research Board (PhD Scholars programme in Health Services Research, Grant No. PHD/2007/16); Science Foundation Ireland (Principal Investigator Award 08/IN.1/B2083; INFANT Centre Grant 12/RC/2272)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationO’Neill, S. M., Agerbo, E., Khashan, A. S., Kearney, P. M., Henriksen, T. B., Greene, R. A. and Kenny, L. C. (2017) ‘Trial of labour after caesarean section and the risk of neonatal and infant death: a nationwide cohort study’, BMC Pregnancy and Childbirth, 17(74), pp. 1-9. doi:10.1186/s12884-017-1255-2en
dc.identifier.doi10.1186/s12884-017-1255-2
dc.identifier.endpage9en
dc.identifier.issn1471-2393
dc.identifier.issued74en
dc.identifier.journaltitleBMC Pregnancy and Childbirthen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/3827
dc.identifier.volume17en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.rights© 2017, the Authors. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectDelivery ratesen
dc.subjectVaginal birthen
dc.subjectRegistrationen
dc.subjectPregnanciesen
dc.subjectRegistersen
dc.subjectOutcomesen
dc.subjectVBACen
dc.subjectTermen
dc.subjectTrial of labouren
dc.subjectNeonatal deathen
dc.subjectRepeat caesarean sectionen
dc.titleTrial of labour after caesarean section and the risk of neonatal and infant death: a nationwide cohort studyen
dc.typeArticle (peer-reviewed)en
Files
Collections
Public Health - Journal Articles
National Perinatal Epidemiology Centre - Journal Articles