Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul 5;9(1):9748.
doi: 10.1038/s41598-019-46153-4.

Pregnancy outcomes of women with previous caesarean sections: Secondary analysis of World Health Organization Multicountry Survey on Maternal and Newborn Health

Chumnan Kietpeerakool  1 , Pisake Lumbiganon  2 , Malinee Laopaiboon  3 , Siwanon Rattanakanokchai  3 , Joshua P Vogel  4 , A Metin Gülmezoglu  4
Affiliations

Pregnancy outcomes of women with previous caesarean sections: Secondary analysis of World Health Organization Multicountry Survey on Maternal and Newborn Health

Chumnan Kietpeerakool et al. Sci Rep. .

Abstract

Secondary analysis of World Health Organization Multicountry Survey on Maternal and Newborn Health (WHOMCS) was undertaken among 173,124 multiparous women to assess the association between previous caesarean sections (CS) and pregnancy outcomes. Maternal outcomes included maternal near miss (MNM), maternal death (MD), severe maternal outcomes (SMO), abnormal placentation, and uterine rupture. Neonatal outcomes were stillbirth, early neonatal death, perinatal death, neonatal near miss (NNM), neonatal intensive care unit (NICU) admission, and preterm birth. Previous CS was associated with increased risks of uterine rupture (adjusted Odds Ratio (aOR); 7.74; 95% confidence interval (CI) 5.48, 10.92); morbidly adherent placenta (aOR 2.60; 95% CI 1.98, 3.40), MNM (aOR 1.91; 95% CI 1.59, 2.28), SMO (aOR 1.80; 95% CI 1.52, 2.13), placenta previa (aOR 1.76; 95% CI 1.49, 2.07). For neonatal outcomes, previous CS was associated with increased risks of NICU admission (aOR 1.31; 95% CI 1.23, 1.39), neonatal near miss (aOR 1.19; 95% CI 1.12, 1.26), preterm birth (aOR 1.07; 95% CI 1.01, 1.14), and decreased risk of macerated stillbirth (aOR 0.80; 95% CI 0.67, 0.95). Previous CS was associated with serious morbidity in future pregnancies. However, these findings should be cautiously interpreted due to lacking data on indications of previous CS.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Population flow chart. Note: *admission for near miss/maternal death who did not experience a delivery or abortion at participating facilities. MNM = maternal near miss, SMO = severe maternal outcome, NNM = neonatal near miss, NICU = neonatal intensive care unit.
See this image and copyright information in PMC

References

    1. Molina G, et al. Relationship Between Cesarean Delivery Rate and Maternal and Neonatal Mortality. JAMA. 2015;314:2263–2270. doi: 10.1001/jama.2015.15553. - DOI - PubMed
    1. Thomas S, Meadows J, McQueen KA. Access to Cesarean Section Will Reduce Maternal Mortality in Low-Income Countries: A Mathematical Model. World J Surg. 2016;40:1537–1541. doi: 10.1007/s00268-016-3479-0. - DOI - PubMed
    1. Shah A, et al. Cesarean delivery outcomes from the WHO global survey on maternal and perinatal health in Africa. Int J Gynaecol Obstet. 2009;107:191–197. doi: 10.1016/j.ijgo.2009.08.013. - DOI - PubMed
    1. Villar J, et al. Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet. 2006;367:1819–1829. doi: 10.1016/S0140-6736(06)68704-7. - DOI - PubMed
    1. Lumbiganon P, et al. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08. Lancet. 2010;375:490–499. doi: 10.1016/S0140-6736(09)61870-5. - DOI - PubMed

Publication types