Long-term maternal outcomes 5 years after cesarean section in Sierra Leone : A prospective cohort study
(2024) In International Journal of Gynecology and Obstetrics- Abstract
Cesarean section (CS) is a life-saving procedure when performed for the right indication but carries substantial risks, specifically during subsequent pregnancies. The aim of this study was to evaluate obstetric outcomes for women 5 years after a CS performed by medical doctors and associate clinicians. This was a prospective multi-center observational study of women who had a CS at any of nine hospitals in Sierra Leone. Women and their offspring were followed up with three home visits for 5 years after surgery. Outcomes of interest included long-term complications, mode and place of delivery, and maternal and pediatric outcomes of subsequent pregnancies. Of the 1274 women included in the study, 140 (11.0%) were lost to follow-up.... (More)
Cesarean section (CS) is a life-saving procedure when performed for the right indication but carries substantial risks, specifically during subsequent pregnancies. The aim of this study was to evaluate obstetric outcomes for women 5 years after a CS performed by medical doctors and associate clinicians. This was a prospective multi-center observational study of women who had a CS at any of nine hospitals in Sierra Leone. Women and their offspring were followed up with three home visits for 5 years after surgery. Outcomes of interest included long-term complications, mode and place of delivery, and maternal and pediatric outcomes of subsequent pregnancies. Of the 1274 women included in the study, 140 (11.0%) were lost to follow-up. Within 5 years after the index CS, 27.0% of the women became pregnant and 2.5% had a second pregnancy. Women with perinatal death at the index CS had 5.25 higher odds of becoming pregnant within 1 year. Of the 259 women who delivered, 31 (12.0%) had a planned CS and 228 (88.0%) attempted a trial of labor after CS, resulting in either a successful vaginal birth (n = 138; 60.5%) or an emergency CS (n = 90; 39.5%). Peripartum and long-term complications did not significantly differ between those that were operated on by medical doctors and associate clinicians. Within 5 years after CS, one in four women became pregnant again and more than half had a vaginal delivery. Significant differences in place and mode of birth between wealth quintiles illustrate inequities.
(Less)
- author
- Logstein, Erika
; Torp, Richard
; Ashley, Thomas
; Kamara, Michael M.
; Koroma, Alimamy P.
; Dumbuya, Abu Bakarr
; Suma, Musa S.
; Moijue, Abdul Rahman
; Westendorp, Josien
; Kujabi, Monica L.
; Rijken, Marcus J.
; Wibe, Arne
; Hagander, Lars
LU
; Leather, Andrew J.M.
; Bolkan, Håkon A.
and van Duinen, Alex J.
LU
(Less) - organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- epub
- subject
- keywords
- cesarean section, long-term outcomes, Sierra Leone, trial of labor after cesarean section, vaginal birth after cesarean section
- in
- International Journal of Gynecology and Obstetrics
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:39487680
- scopus:85208076692
- ISSN
- 0020-7292
- DOI
- 10.1002/ijgo.15996
- language
- English
- LU publication?
- yes
- id
- aa9334fe-e8d9-4dd9-850d-173bb3524acd
- date added to LUP
- 2024-12-11 10:35:06
- date last changed
- 2025-07-10 03:36:55
@article{aa9334fe-e8d9-4dd9-850d-173bb3524acd,
abstract = {{<p>Cesarean section (CS) is a life-saving procedure when performed for the right indication but carries substantial risks, specifically during subsequent pregnancies. The aim of this study was to evaluate obstetric outcomes for women 5 years after a CS performed by medical doctors and associate clinicians. This was a prospective multi-center observational study of women who had a CS at any of nine hospitals in Sierra Leone. Women and their offspring were followed up with three home visits for 5 years after surgery. Outcomes of interest included long-term complications, mode and place of delivery, and maternal and pediatric outcomes of subsequent pregnancies. Of the 1274 women included in the study, 140 (11.0%) were lost to follow-up. Within 5 years after the index CS, 27.0% of the women became pregnant and 2.5% had a second pregnancy. Women with perinatal death at the index CS had 5.25 higher odds of becoming pregnant within 1 year. Of the 259 women who delivered, 31 (12.0%) had a planned CS and 228 (88.0%) attempted a trial of labor after CS, resulting in either a successful vaginal birth (n = 138; 60.5%) or an emergency CS (n = 90; 39.5%). Peripartum and long-term complications did not significantly differ between those that were operated on by medical doctors and associate clinicians. Within 5 years after CS, one in four women became pregnant again and more than half had a vaginal delivery. Significant differences in place and mode of birth between wealth quintiles illustrate inequities.</p>}},
author = {{Logstein, Erika and Torp, Richard and Ashley, Thomas and Kamara, Michael M. and Koroma, Alimamy P. and Dumbuya, Abu Bakarr and Suma, Musa S. and Moijue, Abdul Rahman and Westendorp, Josien and Kujabi, Monica L. and Rijken, Marcus J. and Wibe, Arne and Hagander, Lars and Leather, Andrew J.M. and Bolkan, Håkon A. and van Duinen, Alex J.}},
issn = {{0020-7292}},
keywords = {{cesarean section; long-term outcomes; Sierra Leone; trial of labor after cesarean section; vaginal birth after cesarean section}},
language = {{eng}},
publisher = {{Wiley-Blackwell}},
series = {{International Journal of Gynecology and Obstetrics}},
title = {{Long-term maternal outcomes 5 years after cesarean section in Sierra Leone : A prospective cohort study}},
url = {{http://dx.doi.org/10.1002/ijgo.15996}},
doi = {{10.1002/ijgo.15996}},
year = {{2024}},
}