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Apgar score and perinatal death after one previous caesarean delivery.
BJOG. 2010 Aug; 117(9):1088-97.BJOG

Abstract

OBJECTIVE

To assess the impact of the indication for a previous caesarean section on the outcome of a subsequent delivery.

DESIGN

Population-based cohort study.

SETTING

Sweden.

POPULATION

Women with two deliveries between 1987 and 2007 identified using the Swedish Medical Birth Registry.

METHODS

The outcome of 69 133 pregnancies after one caesarean section was compared with the outcome of 487 610 pregnancies following one vaginal delivery. The indication for the first caesarean section was estimated using a new hierarchical system based on information from birth records.

MAIN OUTCOME MEASURES

Perinatal death, low Apgar score (less than seven at 5 minutes).

RESULTS

Infants of women with one previous caesarean section were at increased risk of low Apgar score compared with infants of women with one previous vaginal delivery (OR, 2.0; 95% CI, 1.9-2.1). The risk estimate was reduced when adjustment for maternal and fetal/infant characteristics was made (OR, 1.6; 95% CI, 1.5-1.8). The corresponding crude and adjusted odds ratios for perinatal death were 1.6 (95% CI, 1.4-1.7) and 1.1 (95% CI, 1.0-1.2), respectively. The infant outcome of the delivery after one caesarean section was mainly dependent on the indication for the first-delivery caesarean section and, when no medical indication was present, no increase in risk was detected.

CONCLUSIONS

Infants of women with one previous caesarean section were at increased risk of low Apgar score and/or perinatal death compared with infants of women with one previous vaginal delivery. The results suggest that medical conditions, not the previous caesarean section per se, contributed to the increase in risk.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Ystad Hospital, Kristianstadsvägen 3, 271 82 Ystad, Sweden. marie.carlsson.wallin@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

20497412

Citation

Carlsson Wallin, M, et al. "Apgar Score and Perinatal Death After One Previous Caesarean Delivery." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 117, no. 9, 2010, pp. 1088-97.
Carlsson Wallin M, Ekström P, Marsál K, et al. Apgar score and perinatal death after one previous caesarean delivery. BJOG. 2010;117(9):1088-97.
Carlsson Wallin, M., Ekström, P., Marsál, K., & Källén, K. (2010). Apgar score and perinatal death after one previous caesarean delivery. BJOG : an International Journal of Obstetrics and Gynaecology, 117(9), 1088-97. https://doi.org/10.1111/j.1471-0528.2010.02614.x
Carlsson Wallin M, et al. Apgar Score and Perinatal Death After One Previous Caesarean Delivery. BJOG. 2010;117(9):1088-97. PubMed PMID: 20497412.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Apgar score and perinatal death after one previous caesarean delivery. AU - Carlsson Wallin,M, AU - Ekström,P, AU - Marsál,K, AU - Källén,K, Y1 - 2010/05/25/ PY - 2010/5/26/entrez PY - 2010/5/26/pubmed PY - 2010/11/3/medline SP - 1088 EP - 97 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 117 IS - 9 N2 - OBJECTIVE: To assess the impact of the indication for a previous caesarean section on the outcome of a subsequent delivery. DESIGN: Population-based cohort study. SETTING: Sweden. POPULATION: Women with two deliveries between 1987 and 2007 identified using the Swedish Medical Birth Registry. METHODS: The outcome of 69 133 pregnancies after one caesarean section was compared with the outcome of 487 610 pregnancies following one vaginal delivery. The indication for the first caesarean section was estimated using a new hierarchical system based on information from birth records. MAIN OUTCOME MEASURES: Perinatal death, low Apgar score (less than seven at 5 minutes). RESULTS: Infants of women with one previous caesarean section were at increased risk of low Apgar score compared with infants of women with one previous vaginal delivery (OR, 2.0; 95% CI, 1.9-2.1). The risk estimate was reduced when adjustment for maternal and fetal/infant characteristics was made (OR, 1.6; 95% CI, 1.5-1.8). The corresponding crude and adjusted odds ratios for perinatal death were 1.6 (95% CI, 1.4-1.7) and 1.1 (95% CI, 1.0-1.2), respectively. The infant outcome of the delivery after one caesarean section was mainly dependent on the indication for the first-delivery caesarean section and, when no medical indication was present, no increase in risk was detected. CONCLUSIONS: Infants of women with one previous caesarean section were at increased risk of low Apgar score and/or perinatal death compared with infants of women with one previous vaginal delivery. The results suggest that medical conditions, not the previous caesarean section per se, contributed to the increase in risk. SN - 1471-0528 UR - https://www.unboundmedicine.com/medline/citation/20497412/Apgar_score_and_perinatal_death_after_one_previous_caesarean_delivery_ L2 - https://doi.org/10.1111/j.1471-0528.2010.02614.x DB - PRIME DP - Unbound Medicine ER -