Vaginal birth after caesarean section: a cohort study investigating factors associated with its uptake and success.


Knight, HE; Gurol-Urganci, I; van der Meulen, JH; Mahmood, TA; Richmond, DH; Dougall, A; Cromwell, DA; (2013) Vaginal birth after caesarean section: a cohort study investigating factors associated with its uptake and success. BJOG, 121 (2). pp. 183-92. ISSN 1470-0328 DOI: https://doi.org/10.1111/1471-0528.12508

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Abstract

OBJECTIVES: To investigate the demographic and obstetric factors associated with the uptake and success rate of vaginal birth after caesarean section (VBAC).<br/> DESIGN: Cohort study using data from Hospital Episode Statistics.<br/> SETTING: English National Health Service.<br/> POPULATION: Women whose first birth resulted in a live singleton delivery by caesarean section between 1 April 2004 and 31 March 2011, and who had a second birth before 31 March 2012.<br/> METHODS: Logistic regression to estimate adjusted odds ratios (OR).<br/> MAIN OUTCOME MEASURES: Attempted and successful VBAC.<br/> RESULTS: Among the 143,970 women in the cohort, 75,086 (52.2%) attempted a VBAC for their second birth. Younger women, those of non-white ethnicity and those living in a more deprived area had higher rates of attempted VBAC. Overall, 47,602 women (63.4%) who attempted a VBAC had a successful vaginal birth. Younger women and women of white ethnicity had higher success rates. Black women had a particularly low success rate (OR, 0.54; 95% confidence interval [CI], 0.50-0.57). Women who had an emergency caesarean section in their first birth also had a lower VBAC success rate, particularly those with a history of failed induction of labour (OR, 0.59; 95% CI, 0.53-0.67).<br/> CONCLUSION: In this national cohort, just over one-half of women with a primary caesarean section who were eligible for a trial of labour attempted a VBAC for their second birth. Of these, almost two-thirds successfully achieved a vaginal delivery.<br/>

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
PubMed ID: 24251861
Web of Science ID: 328863800010
URI: http://researchonline.lshtm.ac.uk/id/eprint/1654951

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