Data from: Impact of caesarean section on mode of delivery, pregnancy-induced and pregnancy-associated disorders, and complications in the subsequent pregnancy in Germany

Objectives: To analyze the impact of caesarean section (CS) on mode of delivery, pregnancy-induced and pregnancy-associated disorders, as well as complications in the subsequent pregnancy within German gynecological practices. Methods: 1,801 women with CS and 1,801 matched women with vaginal delivery (VD) from the IMS Disease Analyzer database were included. The impact of previous CS on the mode of delivery and pregnancy-associated disorders as well as complications prior to or during birth in the subsequent pregnancy were analyzed. Cox regressions were used to determine the influence of CS with regard to these outcomes. Results: Medical abortion and single spontaneous delivery were significantly less frequent in women with a history of CS compared to VD (OR equal to 0.52 and 0.04 respectively), whereas CS after CS was the significantly more common mode of delivery (79.0% versus 9.3%, OR=36.47). Gestational hypertension without significant proteinuria, gestational hypertension with significant proteinuria, and polyhydramnios were more frequent in women with CS than in women with VD (OR equal to 6.80, 1.71, and 2.29). Hemorrhage and maternal care for known or suspected disproportion were more common in the CS group than in the VD group (OR equal to 1.34 and 3.75). Prolonged pregnancy, preterm labor, abnormalities arising from forces of labor, and perineal laceration during delivery were significantly less frequent in women with CS than in women with VD (OR between 0.32 and 0.75), whereas long labor was more common (OR=2.09). Conclusion: Women with CS were more likely to undergo further CS and to develop major pregnancy-associated diseases in the following pregnancy compared to women with VD.

研究目的：分析剖宫产（caesarean section, CS）对分娩方式、妊娠诱发疾病及妊娠相关疾病，以及德国妇科临床场景中后续妊娠并发症的影响。研究方法：纳入IMS疾病分析数据库中的1801名有剖宫产史的女性，以及1801名匹配的阴道分娩（vaginal delivery, VD）女性。分析既往剖宫产史对后续妊娠的分娩方式、妊娠相关疾病，以及分娩前或分娩期间并发症的影响。采用Cox回归分析探讨既往剖宫产对上述结局的影响。研究结果：与阴道分娩组相比，有剖宫产史的女性中药物流产和单次自然分娩的发生率显著更低（比值比（odds ratio, OR）分别为0.52和0.04）；而剖宫产后再次剖宫产成为最常见的分娩方式（79.0% vs 9.3%，OR=36.47）。相较于阴道分娩组，有剖宫产史的女性中无显著蛋白尿的妊娠期高血压、伴显著蛋白尿的妊娠期高血压以及羊水过多的发生率更高（OR分别为6.80、1.71和2.29）。剖宫产组的出血情况以及因已知或可疑头盆不称接受产科干预的情况更为常见（OR分别为1.34和3.75）。而过期妊娠、早产、产力异常以及分娩时会阴裂伤的发生率在有剖宫产史的女性中显著低于阴道分娩组（OR介于0.32至0.75之间），但滞产的发生率更高（OR=2.09）。研究结论：相较于阴道分娩女性，有剖宫产史的女性在后续妊娠中更可能接受再次剖宫产，且更易罹患主要妊娠相关疾病。