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Previous cesarean delivery and risks of placenta previa and placental abruption.
Obstet Gynecol. 2006 Apr; 107(4):771-8.OG

Abstract

OBJECTIVE

To examine the association between cesarean delivery and previa and abruption in subsequent pregnancies.

METHODS

A retrospective cohort study of first 2 (n = 156,475) and first 3 (n = 31,102) consecutive singleton pregnancies using the 1989-1997 Missouri longitudinally linked data were performed. Relative risk (RR) was used to quantify the associations between cesarean delivery and risks of previa and abruption in subsequent pregnancies, after adjusting for several confounders.

RESULTS

Rates of previa and abruption were 4.4 (n = 694) and 7.9 (n = 1,243) per 1,000 births, respectively. The pregnancy after a cesarean delivery was associated with increased risk of previa (0.63%) compared with a vaginal delivery (0.38%, RR 1.5, 95% confidence interval [CI] 1.3-1.8). Cesarean delivery in the first and second births conferred a two-fold increased risk of previa in the third pregnancy (RR 2.0, 95% CI 1.3-3.0) compared with first two vaginal deliveries. Women with a cesarean first birth were more likely to have an abruption in the second pregnancy (0.95%) compared with women who had a vaginal first birth (0.74%, RR 1.3, 95% CI 1.2-1.5). Two consecutive cesarean deliveries were associated with a 30% increased risk of abruption in the third pregnancy (RR 1.3, 95% CI 1.0-1.8). A second pregnancy within a year after a cesarean delivery was associated with increased risks of previa (RR 1.7, 95% CI 0.9-3.1) and abruption (RR 1.5, 95% CI 1.1-2.3).

CONCLUSION

A cesarean first birth is associated with increased risks of previa and abruption in the second pregnancy. There is a dose-response pattern in the risk of previa, with increasing number of prior cesarean deliveries. A short interpregnancy interval is associated with increased risks of previa and abruption.

LEVEL OF EVIDENCE

II-2.

Authors+Show Affiliations

Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick 08901-1977, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

16582111

Citation

Getahun, Darios, et al. "Previous Cesarean Delivery and Risks of Placenta Previa and Placental Abruption." Obstetrics and Gynecology, vol. 107, no. 4, 2006, pp. 771-8.
Getahun D, Oyelese Y, Salihu HM, et al. Previous cesarean delivery and risks of placenta previa and placental abruption. Obstet Gynecol. 2006;107(4):771-8.
Getahun, D., Oyelese, Y., Salihu, H. M., & Ananth, C. V. (2006). Previous cesarean delivery and risks of placenta previa and placental abruption. Obstetrics and Gynecology, 107(4), 771-8.
Getahun D, et al. Previous Cesarean Delivery and Risks of Placenta Previa and Placental Abruption. Obstet Gynecol. 2006;107(4):771-8. PubMed PMID: 16582111.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Previous cesarean delivery and risks of placenta previa and placental abruption. AU - Getahun,Darios, AU - Oyelese,Yinka, AU - Salihu,Hamisu M, AU - Ananth,Cande V, PY - 2006/4/4/pubmed PY - 2006/5/4/medline PY - 2006/4/4/entrez SP - 771 EP - 8 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 107 IS - 4 N2 - OBJECTIVE: To examine the association between cesarean delivery and previa and abruption in subsequent pregnancies. METHODS: A retrospective cohort study of first 2 (n = 156,475) and first 3 (n = 31,102) consecutive singleton pregnancies using the 1989-1997 Missouri longitudinally linked data were performed. Relative risk (RR) was used to quantify the associations between cesarean delivery and risks of previa and abruption in subsequent pregnancies, after adjusting for several confounders. RESULTS: Rates of previa and abruption were 4.4 (n = 694) and 7.9 (n = 1,243) per 1,000 births, respectively. The pregnancy after a cesarean delivery was associated with increased risk of previa (0.63%) compared with a vaginal delivery (0.38%, RR 1.5, 95% confidence interval [CI] 1.3-1.8). Cesarean delivery in the first and second births conferred a two-fold increased risk of previa in the third pregnancy (RR 2.0, 95% CI 1.3-3.0) compared with first two vaginal deliveries. Women with a cesarean first birth were more likely to have an abruption in the second pregnancy (0.95%) compared with women who had a vaginal first birth (0.74%, RR 1.3, 95% CI 1.2-1.5). Two consecutive cesarean deliveries were associated with a 30% increased risk of abruption in the third pregnancy (RR 1.3, 95% CI 1.0-1.8). A second pregnancy within a year after a cesarean delivery was associated with increased risks of previa (RR 1.7, 95% CI 0.9-3.1) and abruption (RR 1.5, 95% CI 1.1-2.3). CONCLUSION: A cesarean first birth is associated with increased risks of previa and abruption in the second pregnancy. There is a dose-response pattern in the risk of previa, with increasing number of prior cesarean deliveries. A short interpregnancy interval is associated with increased risks of previa and abruption. LEVEL OF EVIDENCE: II-2. SN - 0029-7844 UR - https://www.unboundmedicine.com/medline/citation/16582111/Previous_cesarean_delivery_and_risks_of_placenta_previa_and_placental_abruption_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=16582111.ui DB - PRIME DP - Unbound Medicine ER -