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CONFERENCE PROCEEDING
Mode of delivery in the first pregnancy and the potential risk for preterm birth in subsequent pregnancy
1
Department of Midwifery, University of West Attica, Athens, Greece
Publication date: 2023-10-24
Corresponding author
Eur J Midwifery 2023;7(Supplement 1):A86
KEYWORDS
ABSTRACT
Introduction:
An increasing amount of research studies the relationship between the mode of delivery in the first pregnancy and the possibility of preterm birth in a subsequent pregnancy. This study aims to synthesize the available evidence on the mode of delivery and its possible association with an increased risk of subsequent spontaneous preterm birth or indicated preterm birth.
Material and Methods:
A scoping review was performed in Medline and Scopus databases, searching for eligible studies from January 2023 to February 2023. Studies that reported the mode of delivery and the risk of preterm birth in subsequent pregnancies were included. The data was extracted independently by two researchers.
Results:
14 retrospective cohort studies were included in this study. The main research findings were: 1. Caesarean section in previous delivery increased the risk of preterm birth in subsequent delivery1,2 2. Caesarean section if performed in the first stage of delivery or if performed pre-labor is associated with indicated preterm birth3–7 3. Caesarean section in the second stage of delivery was associated with an increase in the risk of spontaneous preterm birth8–11 4. A small number of studies also showed that caesarean section in the first pregnancy was associated with a non-statistically significant increase in the number of preterm births in subsequent pregnancies12-14.
Conclusions:
A caesarean section could increase the risk of preterm birth in subsequent pregnancies and specifically if the caesarian section was performed on the second stage of delivery. This scoping review provides information to midwives and obstetricians, so that they can recognize the association between the previous mode of delivery and the rate of preterm birth in subsequent pregnancies in order to use this information for postpartum counseling. More studies are needed - and specifically prospective cross-sectional studies – which would evaluate and regulate interventions, in order to clarify further whether the prolonged 2nd stage of labor or the caesarean section itself is what causes this association.
An increasing amount of research studies the relationship between the mode of delivery in the first pregnancy and the possibility of preterm birth in a subsequent pregnancy. This study aims to synthesize the available evidence on the mode of delivery and its possible association with an increased risk of subsequent spontaneous preterm birth or indicated preterm birth.
Material and Methods:
A scoping review was performed in Medline and Scopus databases, searching for eligible studies from January 2023 to February 2023. Studies that reported the mode of delivery and the risk of preterm birth in subsequent pregnancies were included. The data was extracted independently by two researchers.
Results:
14 retrospective cohort studies were included in this study. The main research findings were: 1. Caesarean section in previous delivery increased the risk of preterm birth in subsequent delivery1,2 2. Caesarean section if performed in the first stage of delivery or if performed pre-labor is associated with indicated preterm birth3–7 3. Caesarean section in the second stage of delivery was associated with an increase in the risk of spontaneous preterm birth8–11 4. A small number of studies also showed that caesarean section in the first pregnancy was associated with a non-statistically significant increase in the number of preterm births in subsequent pregnancies12-14.
Conclusions:
A caesarean section could increase the risk of preterm birth in subsequent pregnancies and specifically if the caesarian section was performed on the second stage of delivery. This scoping review provides information to midwives and obstetricians, so that they can recognize the association between the previous mode of delivery and the rate of preterm birth in subsequent pregnancies in order to use this information for postpartum counseling. More studies are needed - and specifically prospective cross-sectional studies – which would evaluate and regulate interventions, in order to clarify further whether the prolonged 2nd stage of labor or the caesarean section itself is what causes this association.
CONFLICTS OF INTEREST
The authors have no relevant financial or non-financial interests to disclose.
FUNDING
The authors declare that no funds, grants, or other support were received during the preparation of this research.
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Liu CZ, Ho N, Tanaka K, Lehner C, Sekar R, Amoako AA. Does the length of second stage of labour or second stage caesarean section in nulliparous women increase the risk of preterm birth in subsequent pregnancies? J Perinat Med. 2021;49(2):159-165. doi:10.1515/jpm-2020-0269
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CITATIONS (1):
1.
Cesarean delivery is associated with lower neonatal mortality among breech pregnancies: a systematic review and meta-analysis of preterm deliveries ≤32 weeks of gestation
Vivien Unger, Ákos Gasparics, Zsuzsanna Nagy, Márk Hernádfői, Rita Nagy, Anna Walter, Nelli Farkas, Miklós Szabó, Péter Hegyi, Miklós Garami, Péter Varga
American Journal of Obstetrics and Gynecology
Vivien Unger, Ákos Gasparics, Zsuzsanna Nagy, Márk Hernádfői, Rita Nagy, Anna Walter, Nelli Farkas, Miklós Szabó, Péter Hegyi, Miklós Garami, Péter Varga
American Journal of Obstetrics and Gynecology
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