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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 2/2011

01-08-2011 | Materno-fetal Medicine

The impact of previous cesarean section on the success of future fetal programming pattern

Authors: Hamisu M. Salihu, Chelsea M. Bowen, Ronee E. Wilson, Phillip J. Marty

Published in: Archives of Gynecology and Obstetrics | Issue 2/2011

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Abstract

Purpose

The purpose of this study is to examine whether cesarean section in the first pregnancy is associated with the success or failure of programmed fetal growth phenotypes or patterns in the subsequent pregnancy.

Methods

We analyzed data from a population-based retrospective cohort of singleton deliveries that occurred in the state of Missouri from 1978 to 2005 (n = 1,224,133). The main outcome was neonatal mortality, which was used as an index of the success of fetal programming. Cox proportional hazard and logistic regression models were used to generate point estimates and 95% confidence intervals.

Results

Mothers delivering by cesarean section in the first pregnancy were less likely to deliver subsequent appropriate-for-gestational-age (AGA) neonates (OR 0.91, 95% CI 0.89–0.92) when compared with mothers delivering vaginally. Of the 1,457 neonatal deaths in the second pregnancy, 383 early neonatal and 95 late neonatal deaths were to mothers with cesarean section deliveries in the first pregnancy. When compared with women with a previous vaginal delivery, AGA neonates of women with a primary cesarean section had 20% increased risk of both neonatal (OR 1.20, 95% CI 1.05–1.37) and early neonatal (OR 1.23, 95% CI 1.05–1.43) death.

Conclusion

Our study suggests that previous cesarean section is a risk factor for neonatal mortality among AGA infants of subsequent pregnancy. Future prospective studies are needed to confirm these findings.
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Metadata
Title
The impact of previous cesarean section on the success of future fetal programming pattern
Authors
Hamisu M. Salihu
Chelsea M. Bowen
Ronee E. Wilson
Phillip J. Marty
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
Archives of Gynecology and Obstetrics / Issue 2/2011
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-010-1665-0

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