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The risk of unexplained antepartum stillbirth in second pregnancies following caesarean section in the first pregnancy
Authors:Wood S L  Chen S  Ross S  Sauve R
Institution:Department of Obstetrics and Gynecology, University of Calgary, Foothills Hospital, Calgary, Alberta, Canada;Partnership for Research and Education in Mother's and Infants, Calgary Health Region, Foothills Hospital, Calgary, Alberta, Canada;Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
Abstract:Objective  To determine if a previous caesarean section increases the risk of unexplained antepartum stillbirth in second pregnancies.
Study design  Retrospective cohort study.
Setting  Large Canadian perinatal database.
Population  158 502 second births.
Methods  Data were obtained from a large perinatal database, which supplied data on demographics, pregnancy complications, maternal medical conditions, previous caesarean section and pregnancy outcomes.
Main outcome measures  Total and unexplained stillbirth.
Results  The antepartum stillbirth rate was 3.0/1000 in the previous caesarean section group compared with 2.7/1000 in the previous vaginal delivery group ( P = 0.46). Multivariate logistic regression modelling, including terms for maternal age (polynomial), weight >91 kg, smoking during pregnancy, pre-pregnancy hypertension and diabetes, did not document an association between previous caesarean section and unexplained antepartum stillbirth (OR 1.27, 95% CI 0.92–1.77).
Conclusion  Caesarean section in the first birth does not increase the risk of unexplained antepartum stillbirth in second pregnancies.
Keywords:Caesarean section  risk factors  stillbirth
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