Mode of delivery and subsequent reproductive patterns. A national follow-up study

Caroline Fussing-Clausen; Reynir T Geirsson; Thomas Hansen; Steen Rasmussen; Øjvind Lidegaard; Morten Hedegaard

doi:10.1111/aogs.12469

Mode of delivery and subsequent reproductive patterns. A national follow-up study

Caroline Fussing-Clausen, Reynir T Geirsson, Thomas Hansen, Steen Rasmussen, Øjvind Lidegaard, Morten Hedegaard

Department of Clinical Medicine

5 Citations (Scopus)

Abstract

OBJECTIVE: To investigate associations between mode of delivery and subsequent reproductive outcomes.

DESIGN: Cohort study.

POPULATION: Women with term singleton live births from 1987 to 2009.

SETTING: Denmark, birth registration data.

METHODS: Women with a first singleton delivery after 37 weeks were followed until the end of 2010, from a first birth to include subsequent live births. We used Cox's proportional hazards model stratified by parity to compare the likelihood for subsequent delivery according to mode of delivery at first and later births, estimating maternal age effects and lag time to next delivery.

MAIN OUTCOME MEASURE: Likelihood of a subsequent live-born child by previous delivery mode.

RESULTS: We identified 642,052 women with a first delivery. Compared with women with a non-instrumental vaginal delivery, delivering a child by elective cesarean section implied a 23% (95% CI 0.76-0.787) decreased likelihood for subsequent delivery. Emergency cesarean section meant 16% fewer (95% CI 0.84-0.85), and vaginal instrumental delivery 4% fewer subsequent deliveries (95% CI 0.95-0.96). Hazard ratios were largely unchanged after controlling for parity and year of birth. Small age-trends were seen, with hazard ratios affected by maternal age at birth. Delivery mode at first birth affected marginally the time lag until next birth.

CONCLUSIONS: Fecundity, measured as likelihood of a successive live-born child, varied with mode of delivery at the first and also subsequent births. A first or later delivery by cesarean section implied decreased likelihood of subsequent delivery compared with women with a first vaginal birth.

Original language	English
Journal	Acta Obstetricia et Gynecologica Scandinavica
Volume	93
Issue number	10
Pages (from-to)	1034–1041
Number of pages	8
ISSN	0001-6349
DOIs	https://doi.org/10.1111/aogs.12469
Publication status	Published - 2014

Keywords

Adolescent
Adult
Birth Certificates
Cohort Studies
Delivery, Obstetric
Denmark
Emergencies
Female
Fertility
Humans
Maternal Age
Natural Childbirth
Pregnancy
Pregnancy Outcome
Pregnancy Rate
Proportional Hazards Models
Reproductive History

Access to Document

10.1111/aogs.12469

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/aogs.12469

Cite this

@article{2ee03d59e77a4a78910efeb54e4ef84d,

title = "Mode of delivery and subsequent reproductive patterns. A national follow-up study",

abstract = "OBJECTIVE: To investigate associations between mode of delivery and subsequent reproductive outcomes.DESIGN: Cohort study.POPULATION: Women with term singleton live births from 1987 to 2009.SETTING: Denmark, birth registration data.METHODS: Women with a first singleton delivery after 37 weeks were followed until the end of 2010, from a first birth to include subsequent live births. We used Cox's proportional hazards model stratified by parity to compare the likelihood for subsequent delivery according to mode of delivery at first and later births, estimating maternal age effects and lag time to next delivery.MAIN OUTCOME MEASURE: Likelihood of a subsequent live-born child by previous delivery mode.RESULTS: We identified 642,052 women with a first delivery. Compared with women with a non-instrumental vaginal delivery, delivering a child by elective cesarean section implied a 23% (95% CI 0.76-0.787) decreased likelihood for subsequent delivery. Emergency cesarean section meant 16% fewer (95% CI 0.84-0.85), and vaginal instrumental delivery 4% fewer subsequent deliveries (95% CI 0.95-0.96). Hazard ratios were largely unchanged after controlling for parity and year of birth. Small age-trends were seen, with hazard ratios affected by maternal age at birth. Delivery mode at first birth affected marginally the time lag until next birth.CONCLUSIONS: Fecundity, measured as likelihood of a successive live-born child, varied with mode of delivery at the first and also subsequent births. A first or later delivery by cesarean section implied decreased likelihood of subsequent delivery compared with women with a first vaginal birth.",

keywords = "Adolescent, Adult, Birth Certificates, Cohort Studies, Delivery, Obstetric, Denmark, Emergencies, Female, Fertility, Humans, Maternal Age, Natural Childbirth, Pregnancy, Pregnancy Outcome, Pregnancy Rate, Proportional Hazards Models, Reproductive History",

author = "Caroline Fussing-Clausen and Geirsson, {Reynir T} and Thomas Hansen and Steen Rasmussen and {\O}jvind Lidegaard and Morten Hedegaard",

note = "{\textcopyright} 2014 Nordic Federation of Societies of Obstetrics and Gynecology.",

year = "2014",

doi = "10.1111/aogs.12469",

language = "English",

volume = "93",

pages = "1034–1041",

journal = "Acta Obstetricia et Gynecologica Scandinavica",

issn = "0001-6349",

publisher = "JohnWiley & Sons Ltd",

number = "10",

}

TY - JOUR

T1 - Mode of delivery and subsequent reproductive patterns. A national follow-up study

AU - Fussing-Clausen, Caroline

AU - Geirsson, Reynir T

AU - Hansen, Thomas

AU - Rasmussen, Steen

AU - Lidegaard, Øjvind

AU - Hedegaard, Morten

PY - 2014

Y1 - 2014

N2 - OBJECTIVE: To investigate associations between mode of delivery and subsequent reproductive outcomes.DESIGN: Cohort study.POPULATION: Women with term singleton live births from 1987 to 2009.SETTING: Denmark, birth registration data.METHODS: Women with a first singleton delivery after 37 weeks were followed until the end of 2010, from a first birth to include subsequent live births. We used Cox's proportional hazards model stratified by parity to compare the likelihood for subsequent delivery according to mode of delivery at first and later births, estimating maternal age effects and lag time to next delivery.MAIN OUTCOME MEASURE: Likelihood of a subsequent live-born child by previous delivery mode.RESULTS: We identified 642,052 women with a first delivery. Compared with women with a non-instrumental vaginal delivery, delivering a child by elective cesarean section implied a 23% (95% CI 0.76-0.787) decreased likelihood for subsequent delivery. Emergency cesarean section meant 16% fewer (95% CI 0.84-0.85), and vaginal instrumental delivery 4% fewer subsequent deliveries (95% CI 0.95-0.96). Hazard ratios were largely unchanged after controlling for parity and year of birth. Small age-trends were seen, with hazard ratios affected by maternal age at birth. Delivery mode at first birth affected marginally the time lag until next birth.CONCLUSIONS: Fecundity, measured as likelihood of a successive live-born child, varied with mode of delivery at the first and also subsequent births. A first or later delivery by cesarean section implied decreased likelihood of subsequent delivery compared with women with a first vaginal birth.

AB - OBJECTIVE: To investigate associations between mode of delivery and subsequent reproductive outcomes.DESIGN: Cohort study.POPULATION: Women with term singleton live births from 1987 to 2009.SETTING: Denmark, birth registration data.METHODS: Women with a first singleton delivery after 37 weeks were followed until the end of 2010, from a first birth to include subsequent live births. We used Cox's proportional hazards model stratified by parity to compare the likelihood for subsequent delivery according to mode of delivery at first and later births, estimating maternal age effects and lag time to next delivery.MAIN OUTCOME MEASURE: Likelihood of a subsequent live-born child by previous delivery mode.RESULTS: We identified 642,052 women with a first delivery. Compared with women with a non-instrumental vaginal delivery, delivering a child by elective cesarean section implied a 23% (95% CI 0.76-0.787) decreased likelihood for subsequent delivery. Emergency cesarean section meant 16% fewer (95% CI 0.84-0.85), and vaginal instrumental delivery 4% fewer subsequent deliveries (95% CI 0.95-0.96). Hazard ratios were largely unchanged after controlling for parity and year of birth. Small age-trends were seen, with hazard ratios affected by maternal age at birth. Delivery mode at first birth affected marginally the time lag until next birth.CONCLUSIONS: Fecundity, measured as likelihood of a successive live-born child, varied with mode of delivery at the first and also subsequent births. A first or later delivery by cesarean section implied decreased likelihood of subsequent delivery compared with women with a first vaginal birth.

KW - Adolescent

KW - Adult

KW - Birth Certificates

KW - Cohort Studies

KW - Delivery, Obstetric

KW - Denmark

KW - Emergencies

KW - Female

KW - Fertility

KW - Humans

KW - Maternal Age

KW - Natural Childbirth

KW - Pregnancy

KW - Pregnancy Outcome

KW - Pregnancy Rate

KW - Proportional Hazards Models

KW - Reproductive History

U2 - 10.1111/aogs.12469

DO - 10.1111/aogs.12469

M3 - Journal article

C2 - 25138733

SN - 0001-6349

VL - 93

SP - 1034

EP - 1041

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

IS - 10

ER -

Mode of delivery and subsequent reproductive patterns. A national follow-up study

Abstract

Keywords

Access to Document

Fingerprint

Cite this