Abstract
Several studies and a recent meta-analysis have suggested that previous Cesarean section may increase the risk of stillbirth in a subsequent pregnancy. Given the high rates of Cesarean section in contemporary obstetric practice, this is of considerable public health importance. We sought to evaluate the potential that this association is the result of residual confounding bias. A large perinatal database (Alberta Perinatal Health Project) was searched to identify a matched set of first and second births from the years 1992-2006. Data on pregnancy outcomes, demographics and potential confounding factors were obtained. The cohort was comprised of 98538 matched first and second births. Multivariate analysis did not reveal an association between previous Cesarean section and stillbirth, OR = 1.38 (0.98, 1.93). Restricting the analysis to a low risk group further attenuated the association, OR = .99 (0.62, 1.52). Analysis of the risk by indication for Cesarean section found that the risk was not increased for previous dystocia, OR = .91 (0.53, 1.55) nor for breech presentation, OR = 1.06 (0.50, 2.28) but only for other indications including non reassuring fetal status and fetal distress, OR = 1.96 (1.29, 2.98). The results of our co...Continue Reading
References
Oct 1, 1989·Archives of Disease in Childhood·J W KeelingP M Dunn
Jan 15, 1998·The New England Journal of Medicine·S CnattingiusM S Kramer
Dec 5, 2003·Lancet·Gordon C S SmithRichard Dobbie
Feb 3, 2004·Obstetrics and Gynecology·Marie I Cedergren
Feb 20, 2004·The New England Journal of Medicine·Pamela J SurkanSven Cnattingius
Nov 22, 2005·The Medical Journal of Australia·Lee K TaylorDavid J Henderson-Smart
Feb 2, 2006·Obstetrics and Gynecology·Hamisu M SalihuRussell S Kirby
May 9, 2006·American Journal of Obstetrics and Gynecology·Mert O BahtiyarErrol R Norwitz
Jul 19, 2006·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Rolf RichterJoachim W Dudenhausen
Oct 27, 2006·American Journal of Epidemiology·Gordon C S SmithRichard Dobbie
Jan 31, 2007·BJOG : an International Journal of Obstetrics and Gynaecology·R GrayP Brocklehurst
Feb 3, 2007·Obstetrics and Gynecology·Robyn KennareAnnabelle Chan
Jan 25, 2008·Archives of Gynecology and Obstetrics·Roneé E WilsonHamisu M Salihu
Apr 16, 2008·BJOG : an International Journal of Obstetrics and Gynaecology·S L WoodR Sauve
May 13, 2008·Archives of Gynecology and Obstetrics·Maximilian B FranzFranz Kainer
Aug 22, 2008·BJOG : an International Journal of Obstetrics and Gynaecology·J S Cohain
Oct 23, 2010·Obstetrics and Gynecology·Uma M ReddyJun Zhang
Feb 15, 2011·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Oded OhanaEyal Sheiner
Nov 24, 2011·PloS One·Ashna D MohangooUNKNOWN Euro-Peristat Scientific Committee
Feb 2, 2013·PloS One·Sinéad M O'NeillRichard A Greene
Apr 10, 2013·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·K S JosephLily Lee
Citations
Mar 17, 2017·BJOG : an International Journal of Obstetrics and Gynaecology
Sep 13, 2018·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Marcela C CastilloElizabeth M Stringer
Dec 14, 2017·Epigenetics : Official Journal of the DNA Methylation Society·Anna K KnightAlicia K Smith
Dec 29, 2019·BJOG : an International Journal of Obstetrics and Gynaecology·L VisserM A de Boer
Feb 23, 2020·Obstetrics and Gynecology