The Association of Timing of Repeat Cesarean With Outcomes Among a Cohort of Guatemalan Women With a History of Prior Cesarean Birth [post]

Margo S Harrison, Ana Garces, Lester Figueroa, Jamie Westcott, Michael Hambidge, Nancy F Krebs
2021 unpublished
Background: We intended to observe whether maternal and perinatal/neonatal outcomes of birth vary by timing of repeat cesarean among women with a history of prior cesarean birth in a Guatemalan cohort. Methods: This secondary analysis was conducted using data from a prospective study conducted in communities in Chimaltenango, Guatemala through the Global Network for Women's and Children's Health Research.Results: Between January 2017 and April 2020, 26,465 women delivered; 3,143 (11.9%) of
more » ... women had a singleton gestation and a history of prior cesarean delivery. 2,210 (79.9%) women with a history of prior cesarean birth had data available on mode of delivery and gave birth by repeat cesarean; 1312 (59.4%) were pre-labor cesareans while 896 (40.5%) were intrapartum cesarean births. Risk factors associated with an increased risk of intrapartum cesarean birth included hospital delivery as compared to "other" location (ARR 1.6 [1.2,2.1]) and dysfunctional labor (ARR 1.6 [1.4,1.9]). Variables associated with a reduced risk of intrapartum cesarean birth were hypertensive disease (ARR 0.7 [0.6,0.9]), schooling (ARR 0.9 [0.8,0.9]), and increasing age, which was associated with a very slight reduction in the outcome (ARR 0.99 [0.98,0.99]). Maternal and neonatal outcomes did not vary by type of cesarean birth. Conclusion: Outcomes of cesarean birth do not seem to vary by timing of repeat cesarean birth, with hypertensive disease increasing the likelihood of pre-labor cesarean. This information might be useful in counseling women that outcomes after failed trial of labor do not appear worse than those after pre-labor cesarean birth.
doi:10.21203/ fatcat:i6fjtw7vxbcybifobm3lbgigdq