Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/98428
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Type: Journal article
Title: Optimal timing of delivery among low-risk women with prior caesarean section: a secondary analysis of the WHO multicountry survey on maternal and newborn health
Author: Ganchimeg, T.
Nagata, C.
Vogel, J.
Morisaki, N.
Pileggi-Castro, C.
Ortiz-Panozo, E.
Jayaratne, K.
Mittal, S.
Ota, E.
Souza, J.
Mori, R.
Crowther, C.
WHO Multicountry Survey on Maternal and Newborn Health Research Network
Citation: PLoS One, 2016; 11(2):e0149091-1-e0149091-12
Publisher: Public Library of Science
Issue Date: 2016
ISSN: 1932-6203
1932-6203
Editor: Räisänen, S.
Statement of
Responsibility: 
Togoobaatar Ganchimeg, Chie Nagata, Joshua P. Vogel, Naho Morisaki, Cynthia Pileggi-Castro, Eduardo Ortiz-Panozo, Kapila Jayaratne, Suneeta Mittal, Erika Ota, João Paulo Souza, Rintaro Mori, WHO Multicountry Survey on Maternal and Newborn Health Research Network
Abstract: Objective: To investigate optimal timing of elective repeat caesarean section among low-risk pregnant women with prior caesarean section in a multicountry sample from largely low- and middle-income countries. Design: Secondary analysis of a cross-sectional study. Setting: Twenty-nine countries from the World Health Organization Multicountry Survey on Maternal and Newborn Health. Population: 29,647 women with prior caesarean section and no pregnancy complications in their current pregnancy who delivered a term singleton (live birth and stillbirth) at gestational age 37–41 weeks by pre-labour caesarean section, intra-partum caesarean section, or vaginal birth following spontaneous onset of labour. Methods: We compared the rate of short-term adverse maternal and newborn outcomes following pre-labour caesarean section at a given gestational age, to those following ongoing pregnancies beyond that gestational age. Main Outcome Measures: Severe maternal outcomes, neonatal morbidity, and intra-hospital early neonatal mortality. Results: Odds of neonatal morbidity and intra-hospital early neonatal mortality were 0.48 (95% confidence interval [CI] 0.39–0.60) and 0.31 (95% CI 0.16–0.58) times lower for ongoing pregnancies compared to pre-labour caesarean section at 37 weeks. We did not find any significant change in the risk of severe maternal outcomes between pre-labour caesarean section at a given gestational age and ongoing pregnancies beyond that gestational age. Conclusions: Elective repeat caesarean section at 37 weeks had higher risk of neonatal morbidity and mortality compared to ongoing pregnancy, however risks at later gestational ages did not differ between groups.
Keywords: WHO Multicountry Survey on Maternal and Newborn Health Research Network
Humans
Pregnancy Outcome
Delivery, Obstetric
Cesarean Section
Infant Mortality
Maternal Mortality
Odds Ratio
Risk Factors
Cross-Sectional Studies
Gestational Age
Pregnancy
Poverty
Adolescent
Adult
Infant
Infant, Newborn
World Health Organization
Female
Young Adult
Elective Surgical Procedures
Maternal Health
Infant Health
Description: Caroline Crowther is a member of the WHO Multicountry Survey on Maternal and Newborn Health Research Network
Rights: © 2016 Ganchimeg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
DOI: 10.1371/journal.pone.0149091
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