The effect of prematurity on vaginal birth after cesarean delivery

Success and maternal morbidity

Joanne N. Quiñones, David M. Stamilio, Emmanuelle Pare, Jeffrey F. Peipert, Erika Stevens, George A. Macones

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

OBJECTIVE: We sought to compare vaginal birth after cesarean (VBAC) success and uterine rupture rates between preterm and term gestations in women with a history of one prior cesarean delivery. Our hypothesis was that pre-term women undergoing VBAC were more likely to be successful and have a lower rate of complications than term women undergoing VBAC. METHODS: We reviewed medical records of women with a history of a cesarean delivery who either attempted a VBAC or underwent a repeat cesarean delivery from 1995 through 2000 in 17 community and university hospitals. We collected information on demographics, medical and obstetric history, complications, and outcome of the index pregnancy. The primary analysis was limited to women with singleton gestations and one prior cesarean delivery. Statistical analysis consisted of bivariate and multivariable techniques. RESULTS: Among the 20,156 patients with one prior cesarean delivery, 12,463 (61%) attempted a VBAC. Mean gestational ages for the term and preterm women were 39.2 weeks and 33.9 weeks of gestation, respectively. The VBAC success rates for the term and preterm groups were 74% and 82%, respectively (P <.001). Multivariable analysis showed that the VBAC success was higher (adjusted odds ratio 1.54, 95% confidence interval 1.27-1.86) in preterm gestations. A decreased risk of rupture among preterm gestations was suggested in these results (adjusted odds ratio 0.28, 95% confidence interval 0.07-1.17; P = .08). CONCLUSION: Preterm patients undergoing a VBAC have higher success rates when compared with term patients undergoing a VBAC. Preterm patients undergoing VBAC may have lower uterine rupture rates.

Original languageEnglish (US)
Pages (from-to)519-524
Number of pages6
JournalObstetrics and Gynecology
Volume105
Issue number3
DOIs
StatePublished - Mar 2005
Externally publishedYes

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Vaginal Birth after Cesarean
Mothers
Morbidity
Pregnancy
Uterine Rupture
Odds Ratio
Confidence Intervals
Community Hospital
Pregnancy Outcome
Gestational Age
Obstetrics
Medical Records
Rupture

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

The effect of prematurity on vaginal birth after cesarean delivery : Success and maternal morbidity. / Quiñones, Joanne N.; Stamilio, David M.; Pare, Emmanuelle; Peipert, Jeffrey F.; Stevens, Erika; Macones, George A.

In: Obstetrics and Gynecology, Vol. 105, No. 3, 03.2005, p. 519-524.

Research output: Contribution to journalArticle

Quiñones, Joanne N. ; Stamilio, David M. ; Pare, Emmanuelle ; Peipert, Jeffrey F. ; Stevens, Erika ; Macones, George A. / The effect of prematurity on vaginal birth after cesarean delivery : Success and maternal morbidity. In: Obstetrics and Gynecology. 2005 ; Vol. 105, No. 3. pp. 519-524.
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