dc.contributor.author	O'Neill, Sinéad M.
dc.contributor.author	Agerbo, Esben
dc.contributor.author	Khashan, Ali S.
dc.contributor.author	Kearney, Patricia M.
dc.contributor.author	Henriksen, Tine B.
dc.contributor.author	Greene, Richard A.
dc.contributor.author	Kenny, Louise C.
dc.contributor.funder	Health Research Board	en
dc.contributor.funder	Science Foundation Ireland	en
dc.date.accessioned	2017-03-24T11:30:45Z
dc.date.available	2017-03-24T11:30:45Z
dc.date.issued	2017-02-27
dc.date.updated	2017-03-24T10:17:38Z
dc.description.abstract	Background: 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.sponsorship	Health 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.status	Peer reviewed	en
dc.description.version	Published Version	en
dc.format.mimetype	application/pdf	en
dc.identifier.citation	O’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/s12884-017-1255-2	en
dc.identifier.doi	10.1186/s12884-017-1255-2
dc.identifier.endpage	9	en
dc.identifier.issn	1471-2393
dc.identifier.issued	74	en
dc.identifier.journaltitle	BMC Pregnancy and Childbirth	en
dc.identifier.startpage	1	en
dc.identifier.uri	https://hdl.handle.net/10468/3827
dc.identifier.volume	17	en
dc.language.iso	en	en
dc.publisher	BioMed Central	en
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.uri	http://creativecommons.org/licenses/by/4.0/	en
dc.subject	Delivery rates	en
dc.subject	Vaginal birth	en
dc.subject	Registration	en
dc.subject	Pregnancies	en
dc.subject	Registers	en
dc.subject	Outcomes	en
dc.subject	VBAC	en
dc.subject	Term	en
dc.subject	Trial of labour	en
dc.subject	Neonatal death	en
dc.subject	Repeat caesarean section	en
dc.title	Trial of labour after caesarean section and the risk of neonatal and infant death: a nationwide cohort study	en
dc.type	Article (peer-reviewed)	en

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

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