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Obstetrics & Gynecology 2001;97:765-769
© 2001 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

First-Birth Cesarean and Placental Abruption or Previa at Second Birth

MONA LYDON-ROCHELLE, MPH, PhD, VICTORIA L. HOLT, MPH, PhD, THOMAS R. EASTERLING, MD and DIANE P. MARTIN, MA, PhD

From the Department of Health Services, School of Public Health and Community Medicine; Department of Family and Child Nursing, School of Nursing; Department of Epidemiology, School of Public Health and Community Medicine; and Department of Obstetrics and Gynecology, School of Medicine, University of Washington, Seattle, Washington.

Address reprint requests to: Mona Lydon-Rochelle, PhD, MPH Center for Women’s Health Research Mailstop 357262 University of Washington Seattle, WA 98195-7262 E-mail: minot{at}u.washington.edu

Objective: To assess the association between first-birth cesarean delivery and second-birth placental abruption and previa.

Methods: We conducted a population-based, retrospective cohort analysis using data from the Washington State Birth Events Record Database. The study cohort included all primiparas who gave birth to live singleton infants in nonfederal short-stay hospitals from January 1, 1987, through December 31, 1996, and who had second singleton births during the same period (n = 96,975). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for placental abruption or previa at second births associated with first-birth cesareans.

Results: Among our study cohort, abruptio placentae complicated 11.5 per 1000 and placenta previa 5.2 per 1000 singleton deliveries at second births. In logistic regression analyses adjusted for maternal age, women with first-birth cesareans had significantly increased risk of abruptio placentae (OR 1.3, 95% CI 1.1, 1.5), and placenta previa (OR 1.4, 95% CI 1.1, 1.6) at second births, compared with women with prior vaginal deliveries.

Conclusion: We found moderately increased risk of placental abruption and previa as a long-term effect of prior cesarean delivery on second births.




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