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  • Original Article
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Vaginal birth after cesarean success in high-risk women: a population-based study

Abstract

Objective:

The study aim was to identify factors associated with vaginal birth after cesarean (VBAC) in high-risk women.

Study Design:

This is a population-based retrospective cohort study of all births in Ohio during 2006 and 2007. High-risk patients were defined as singleton gestations in women with one previous cesarean who had 1 of the following risk factors: body mass index (BMI)30, hypertension, or diabetes. Multivariate logistic regression was utilized to estimate the relative influence of each factor on successful VBAC.

Result:

A total of 280 882 births were analyzed: of them, 79 084 (27.1%) were high-risk pregnancies and 8658 (10.9%) women had undergone one previous cesarean; 1433 (16.6%) underwent a trial of labor after cesarean (TOLAC). Of them, 974 (68.0%) had a successful VBAC, whereas 459 (32.0%) did not. Factors significantly associated with VBAC success were as follows: a prior vaginal delivery; pregnancy weight gain 30 lbs; Caucasian race; and labor augmentation.

Conclusion:

High-risk women with one prior cesarean are unlikely to undergo a TOLAC, but have a high rate of VBAC.

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Acknowledgements

All of the analyses, interpretations and conclusions that were derived from the data source and included in this article are those of the authors and not of the Ohio Department of Health. Access to de-identified Ohio birth certificate data was provided by the Child Policy Research Center of Cincinnati Children's Hospital Medical Center.

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Correspondence to J Regan.

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The authors declare no conflict of interest.

Additional information

Presented at the Society for Gynecological Investigation 59th Annual Meeting, San Diego, CA, USA, 21–24 March 2012.

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Regan, J., Keup, C., Wolfe, K. et al. Vaginal birth after cesarean success in high-risk women: a population-based study. J Perinatol 35, 252–257 (2015). https://doi.org/10.1038/jp.2014.196

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