Does caesarean delivery in the first pregnancy increase the risk for adverse outcome in the second? A registry-based cohort study on first and second singleton births in Norway

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Standard

Does caesarean delivery in the first pregnancy increase the risk for adverse outcome in the second? A registry-based cohort study on first and second singleton births in Norway. / Bjellmo, Solveig; Andersen, Guro L.; Hjelle, Sissel; Klungsøyr, Kari; Krebs, Lone; Lydersen, Stian; Romundstad, Pål Richard; Vik, Torstein.

In: BMJ Open, Vol. 10, No. 8, e037717, 23.08.2020.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Bjellmo, S, Andersen, GL, Hjelle, S, Klungsøyr, K, Krebs, L, Lydersen, S, Romundstad, PR & Vik, T 2020, 'Does caesarean delivery in the first pregnancy increase the risk for adverse outcome in the second? A registry-based cohort study on first and second singleton births in Norway', BMJ Open, vol. 10, no. 8, e037717. https://doi.org/10.1136/bmjopen-2020-037717

APA

Bjellmo, S., Andersen, G. L., Hjelle, S., Klungsøyr, K., Krebs, L., Lydersen, S., Romundstad, P. R., & Vik, T. (2020). Does caesarean delivery in the first pregnancy increase the risk for adverse outcome in the second? A registry-based cohort study on first and second singleton births in Norway. BMJ Open, 10(8), [e037717]. https://doi.org/10.1136/bmjopen-2020-037717

Vancouver

Bjellmo S, Andersen GL, Hjelle S, Klungsøyr K, Krebs L, Lydersen S et al. Does caesarean delivery in the first pregnancy increase the risk for adverse outcome in the second? A registry-based cohort study on first and second singleton births in Norway. BMJ Open. 2020 Aug 23;10(8). e037717. https://doi.org/10.1136/bmjopen-2020-037717

Author

Bjellmo, Solveig ; Andersen, Guro L. ; Hjelle, Sissel ; Klungsøyr, Kari ; Krebs, Lone ; Lydersen, Stian ; Romundstad, Pål Richard ; Vik, Torstein. / Does caesarean delivery in the first pregnancy increase the risk for adverse outcome in the second? A registry-based cohort study on first and second singleton births in Norway. In: BMJ Open. 2020 ; Vol. 10, No. 8.

Bibtex

@article{5fdfe7b1715542ec83078eaa81434455,
title = "Does caesarean delivery in the first pregnancy increase the risk for adverse outcome in the second?: A registry-based cohort study on first and second singleton births in Norway",
abstract = "Objective To explore if newborns in the second pregnancy following a previous caesarean delivery (CD) have higher risk of perinatal mortality or cerebral palsy than newborns in pregnancies following a previous vaginal delivery (VD). Design Cohort study with information from the Medical Birth Registry of Norway and the Cerebral Palsy Registry of Norway. Setting Births in Norway. Participants 294 598 women with their first and second singleton delivery during 1996-2015. Main outcome measures Stillbirth, perinatal mortality, neonatal mortality and cerebral palsy. Results Among 294 598 included women, 42 962 (15%) had a CD in their first pregnancy while 251 636 (85%) had a VD. Compared with the second delivery of mothers with a previous VD, the adjusted OR (adjOR), for stillbirth in the second pregnancy following a previous CD was 1.45, 95% CI 1.22 to 1.73; for perinatal death the adjOR was 1.42 (1.22 to 1.73) and for neonatal death 1.13 (0.86 to 1.49). Among children who survived the neonatal period, the adjOR for cerebral palsy was 1.27 (0.99 to 1.64). Secondary outcomes, including small for gestational age, preterm and very preterm birth, uterine rupture and placental complications (eg, postpartum haemorrhage and pre-eclampsia) were more frequent in the subsequent pregnancy following a previous CD compared with a previous VD, in particular for uterine rupture adjOR 86.7 (48.2 to 156.1). Adjustment for potential confounders attenuated the ORs somewhat, but the excess risk in the second pregnancy persisted for all outcomes. Conclusion A previous CD was in this study associated with increased risk for stillbirth and perinatal death compared with a previous VD. Although less robust, we also found that a previous CD was associated with a slightly increased risk of cerebral palsy among children surviving the neonatal period. The aetiology behind these associations needs further investigation.",
keywords = "epidemiology, maternal medicine, neonatology, obstetrics",
author = "Solveig Bjellmo and Andersen, {Guro L.} and Sissel Hjelle and Kari Klungs{\o}yr and Lone Krebs and Stian Lydersen and Romundstad, {P{\aa}l Richard} and Torstein Vik",
year = "2020",
month = aug,
day = "23",
doi = "10.1136/bmjopen-2020-037717",
language = "English",
volume = "10",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "8",

}

RIS

TY - JOUR

T1 - Does caesarean delivery in the first pregnancy increase the risk for adverse outcome in the second?

T2 - A registry-based cohort study on first and second singleton births in Norway

AU - Bjellmo, Solveig

AU - Andersen, Guro L.

AU - Hjelle, Sissel

AU - Klungsøyr, Kari

AU - Krebs, Lone

AU - Lydersen, Stian

AU - Romundstad, Pål Richard

AU - Vik, Torstein

PY - 2020/8/23

Y1 - 2020/8/23

N2 - Objective To explore if newborns in the second pregnancy following a previous caesarean delivery (CD) have higher risk of perinatal mortality or cerebral palsy than newborns in pregnancies following a previous vaginal delivery (VD). Design Cohort study with information from the Medical Birth Registry of Norway and the Cerebral Palsy Registry of Norway. Setting Births in Norway. Participants 294 598 women with their first and second singleton delivery during 1996-2015. Main outcome measures Stillbirth, perinatal mortality, neonatal mortality and cerebral palsy. Results Among 294 598 included women, 42 962 (15%) had a CD in their first pregnancy while 251 636 (85%) had a VD. Compared with the second delivery of mothers with a previous VD, the adjusted OR (adjOR), for stillbirth in the second pregnancy following a previous CD was 1.45, 95% CI 1.22 to 1.73; for perinatal death the adjOR was 1.42 (1.22 to 1.73) and for neonatal death 1.13 (0.86 to 1.49). Among children who survived the neonatal period, the adjOR for cerebral palsy was 1.27 (0.99 to 1.64). Secondary outcomes, including small for gestational age, preterm and very preterm birth, uterine rupture and placental complications (eg, postpartum haemorrhage and pre-eclampsia) were more frequent in the subsequent pregnancy following a previous CD compared with a previous VD, in particular for uterine rupture adjOR 86.7 (48.2 to 156.1). Adjustment for potential confounders attenuated the ORs somewhat, but the excess risk in the second pregnancy persisted for all outcomes. Conclusion A previous CD was in this study associated with increased risk for stillbirth and perinatal death compared with a previous VD. Although less robust, we also found that a previous CD was associated with a slightly increased risk of cerebral palsy among children surviving the neonatal period. The aetiology behind these associations needs further investigation.

AB - Objective To explore if newborns in the second pregnancy following a previous caesarean delivery (CD) have higher risk of perinatal mortality or cerebral palsy than newborns in pregnancies following a previous vaginal delivery (VD). Design Cohort study with information from the Medical Birth Registry of Norway and the Cerebral Palsy Registry of Norway. Setting Births in Norway. Participants 294 598 women with their first and second singleton delivery during 1996-2015. Main outcome measures Stillbirth, perinatal mortality, neonatal mortality and cerebral palsy. Results Among 294 598 included women, 42 962 (15%) had a CD in their first pregnancy while 251 636 (85%) had a VD. Compared with the second delivery of mothers with a previous VD, the adjusted OR (adjOR), for stillbirth in the second pregnancy following a previous CD was 1.45, 95% CI 1.22 to 1.73; for perinatal death the adjOR was 1.42 (1.22 to 1.73) and for neonatal death 1.13 (0.86 to 1.49). Among children who survived the neonatal period, the adjOR for cerebral palsy was 1.27 (0.99 to 1.64). Secondary outcomes, including small for gestational age, preterm and very preterm birth, uterine rupture and placental complications (eg, postpartum haemorrhage and pre-eclampsia) were more frequent in the subsequent pregnancy following a previous CD compared with a previous VD, in particular for uterine rupture adjOR 86.7 (48.2 to 156.1). Adjustment for potential confounders attenuated the ORs somewhat, but the excess risk in the second pregnancy persisted for all outcomes. Conclusion A previous CD was in this study associated with increased risk for stillbirth and perinatal death compared with a previous VD. Although less robust, we also found that a previous CD was associated with a slightly increased risk of cerebral palsy among children surviving the neonatal period. The aetiology behind these associations needs further investigation.

KW - epidemiology

KW - maternal medicine

KW - neonatology

KW - obstetrics

U2 - 10.1136/bmjopen-2020-037717

DO - 10.1136/bmjopen-2020-037717

M3 - Journal article

C2 - 32830116

AN - SCOPUS:85089794208

VL - 10

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 8

M1 - e037717

ER -

ID: 248603732