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Risk factors for uterine rupture and neonatal consequences of uterine rupture: a population-based study of successive pregnancies in Sweden.
BJOG. 2007 Oct; 114(10):1208-14.BJOG

Abstract

OBJECTIVE

Uterine rupture is a rare but a catastrophic event. The aim of the present study was to explore the risk factors for uterine rupture and associated neonatal morbidity and mortality among a cohort of Swedish women attempting vaginal birth in their second delivery.

DESIGN

Population-based cohort study.

SETTING

Sweden.

POPULATION

A total of 300,200 Swedish women delivering two single consecutive births between 1983 and 2001.

METHODS

Swedish population-based registers were used to obtain information concerning demographics, pregnancy and birth characteristics, and neonatal outcomes. Logistic regression was used to analyse potential risk factors for uterine rupture and risk of neonatal mortality associated with uterine rupture. Odds ratios were used to estimate relative risks using 95% CI.

MAIN OUTCOME MEASURE

Uterine rupture and neonatal mortality in the second pregnancy.

RESULTS

Compared with women who delivered vaginally in their first birth, women who underwent a caesarean delivery were, during their second delivery, at increased risk of uterine rupture (adjusted OR 41.79; 95% CI 29.73-57.00). Induction of labour, high (> or = 4000 g) birthweight, postterm (> or = 42 weeks) births, high (> or = 35 years) maternal age, and short (< or = 164 cm) maternal stature were also associated with increased risk of uterine rupture. Uterine rupture was associated with a substantially increased risk in neonatal mortality (adjusted OR 65.62; 95% CI 32.60-132.08).

CONCLUSION

The risk of uterine rupture in subsequent deliveries is not only markedly increased among women with a previous caesarean delivery but also influenced by induction of labour, birthweight, gestational age, and maternal characteristics.

Authors+Show Affiliations

Department of Epidemiology, Emory University, School of Public Health, Atlanta, GA 30307, USA. mkaczma@sph.emory.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17877673

Citation

Kaczmarczyk, M, et al. "Risk Factors for Uterine Rupture and Neonatal Consequences of Uterine Rupture: a Population-based Study of Successive Pregnancies in Sweden." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 114, no. 10, 2007, pp. 1208-14.
Kaczmarczyk M, Sparén P, Terry P, et al. Risk factors for uterine rupture and neonatal consequences of uterine rupture: a population-based study of successive pregnancies in Sweden. BJOG. 2007;114(10):1208-14.
Kaczmarczyk, M., Sparén, P., Terry, P., & Cnattingius, S. (2007). Risk factors for uterine rupture and neonatal consequences of uterine rupture: a population-based study of successive pregnancies in Sweden. BJOG : an International Journal of Obstetrics and Gynaecology, 114(10), 1208-14.
Kaczmarczyk M, et al. Risk Factors for Uterine Rupture and Neonatal Consequences of Uterine Rupture: a Population-based Study of Successive Pregnancies in Sweden. BJOG. 2007;114(10):1208-14. PubMed PMID: 17877673.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for uterine rupture and neonatal consequences of uterine rupture: a population-based study of successive pregnancies in Sweden. AU - Kaczmarczyk,M, AU - Sparén,P, AU - Terry,P, AU - Cnattingius,S, PY - 2007/9/20/pubmed PY - 2007/10/20/medline PY - 2007/9/20/entrez SP - 1208 EP - 14 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 114 IS - 10 N2 - OBJECTIVE: Uterine rupture is a rare but a catastrophic event. The aim of the present study was to explore the risk factors for uterine rupture and associated neonatal morbidity and mortality among a cohort of Swedish women attempting vaginal birth in their second delivery. DESIGN: Population-based cohort study. SETTING: Sweden. POPULATION: A total of 300,200 Swedish women delivering two single consecutive births between 1983 and 2001. METHODS: Swedish population-based registers were used to obtain information concerning demographics, pregnancy and birth characteristics, and neonatal outcomes. Logistic regression was used to analyse potential risk factors for uterine rupture and risk of neonatal mortality associated with uterine rupture. Odds ratios were used to estimate relative risks using 95% CI. MAIN OUTCOME MEASURE: Uterine rupture and neonatal mortality in the second pregnancy. RESULTS: Compared with women who delivered vaginally in their first birth, women who underwent a caesarean delivery were, during their second delivery, at increased risk of uterine rupture (adjusted OR 41.79; 95% CI 29.73-57.00). Induction of labour, high (> or = 4000 g) birthweight, postterm (> or = 42 weeks) births, high (> or = 35 years) maternal age, and short (< or = 164 cm) maternal stature were also associated with increased risk of uterine rupture. Uterine rupture was associated with a substantially increased risk in neonatal mortality (adjusted OR 65.62; 95% CI 32.60-132.08). CONCLUSION: The risk of uterine rupture in subsequent deliveries is not only markedly increased among women with a previous caesarean delivery but also influenced by induction of labour, birthweight, gestational age, and maternal characteristics. SN - 1471-0528 UR - https://www.unboundmedicine.com/medline/citation/17877673/Risk_factors_for_uterine_rupture_and_neonatal_consequences_of_uterine_rupture:_a_population_based_study_of_successive_pregnancies_in_Sweden_ L2 - https://doi.org/10.1111/j.1471-0528.2007.01484.x DB - PRIME DP - Unbound Medicine ER -