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Apgar score and perinatal death after one previous caesarean delivery

Wallin, M. Carlsson; Ekstrom, P.; Marsal, Karel LU and Källén, Karin LU (2010) In BJOG: An International Journal of Obstetrics & Gynaecology2000-01-01+01:00 117(9). p.1088-1097
Abstract
Objective To assess the impact of the indication for a previous caesarean section on the outcome of a subsequent delivery. Design Population-based cohort study. Setting Sweden. Population Women with two deliveries between 1987 and 2007 identified using the Swedish Medical Birth Registry. Methods The outcome of 69 133 pregnancies after one caesarean section was compared with the outcome of 487 610 pregnancies following one vaginal delivery. The indication for the first caesarean section was estimated using a new hierarcharchical system based on information from birth records. Main outcome measures Perinatal death, low Apgar score (less than seven at 5 minutes). Results Infants of women with one previous caesarean section were at increased... (More)
Objective To assess the impact of the indication for a previous caesarean section on the outcome of a subsequent delivery. Design Population-based cohort study. Setting Sweden. Population Women with two deliveries between 1987 and 2007 identified using the Swedish Medical Birth Registry. Methods The outcome of 69 133 pregnancies after one caesarean section was compared with the outcome of 487 610 pregnancies following one vaginal delivery. The indication for the first caesarean section was estimated using a new hierarcharchical system based on information from birth records. Main outcome measures Perinatal death, low Apgar score (less than seven at 5 minutes). Results Infants of women with one previous caesarean section were at increased risk of low Apgar score compared with infants of women with one previous vaginal delivery (OR, 2.0; 95% CI, 1.9-2.1). The risk estimate was reduced when adjustment for maternal and fetal/infant characteristics was made (OR, 1.6; 95% CI, 1.5-1.8). The corresponding crude and adjusted odds ratios for perinatal death were 1.6 (95% CI, 1.4-1.7) and 1.1 (95% CI, 1.0-1.2), respectively. The infant outcome of the delivery after one caesarean section was mainly dependent on the indication for the first-delivery caesarean section and, when no medical indication was present, no increase in risk was detected. Conclusions Infants of women with one previous caesarean section were at increased risk of low Apgar score and/or perinatal death compared with infants of women with one previous vaginal delivery. The results suggest that medical conditions, not the previous caesarean section per se, contributed to the increase in risk. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
perinatal death, Apgar score, caesarean section, Sweden
in
BJOG: An International Journal of Obstetrics & Gynaecology2000-01-01+01:00
volume
117
issue
9
pages
1088 - 1097
publisher
Wiley-Blackwell
external identifiers
  • wos:000279532500009
  • scopus:77954410397
ISSN
1471-0528
DOI
10.1111/j.1471-0528.2010.02614.x
language
English
LU publication?
yes
id
41e6f699-dc40-4417-a25b-1dc8846f352a (old id 1658058)
date added to LUP
2010-08-20 09:08:34
date last changed
2018-05-29 11:25:34
@article{41e6f699-dc40-4417-a25b-1dc8846f352a,
  abstract     = {Objective To assess the impact of the indication for a previous caesarean section on the outcome of a subsequent delivery. Design Population-based cohort study. Setting Sweden. Population Women with two deliveries between 1987 and 2007 identified using the Swedish Medical Birth Registry. Methods The outcome of 69 133 pregnancies after one caesarean section was compared with the outcome of 487 610 pregnancies following one vaginal delivery. The indication for the first caesarean section was estimated using a new hierarcharchical system based on information from birth records. Main outcome measures Perinatal death, low Apgar score (less than seven at 5 minutes). Results Infants of women with one previous caesarean section were at increased risk of low Apgar score compared with infants of women with one previous vaginal delivery (OR, 2.0; 95% CI, 1.9-2.1). The risk estimate was reduced when adjustment for maternal and fetal/infant characteristics was made (OR, 1.6; 95% CI, 1.5-1.8). The corresponding crude and adjusted odds ratios for perinatal death were 1.6 (95% CI, 1.4-1.7) and 1.1 (95% CI, 1.0-1.2), respectively. The infant outcome of the delivery after one caesarean section was mainly dependent on the indication for the first-delivery caesarean section and, when no medical indication was present, no increase in risk was detected. Conclusions Infants of women with one previous caesarean section were at increased risk of low Apgar score and/or perinatal death compared with infants of women with one previous vaginal delivery. The results suggest that medical conditions, not the previous caesarean section per se, contributed to the increase in risk.},
  author       = {Wallin, M. Carlsson and Ekstrom, P. and Marsal, Karel and Källén, Karin},
  issn         = {1471-0528},
  keyword      = {perinatal death,Apgar score,caesarean section,Sweden},
  language     = {eng},
  number       = {9},
  pages        = {1088--1097},
  publisher    = {Wiley-Blackwell},
  series       = {BJOG: An International Journal of Obstetrics & Gynaecology2000-01-01+01:00},
  title        = {Apgar score and perinatal death after one previous caesarean delivery},
  url          = {http://dx.doi.org/10.1111/j.1471-0528.2010.02614.x},
  volume       = {117},
  year         = {2010},
}