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.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
National Institutes of Health. National Institutes of Health and Consensus Development Statement on vaginal birth after cesarean: new insights March 8-10. Semin Perinatol 2010; 34 (5): 351–365.
Landon MB, Hauth JC, Leveno KJ, Spong CY, Leindecker S, Varner MW et al. Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. N Engl J Med 2004; 351 (25): 2581–2589.
American College of Obstetricians and Gynecologists. The American College of Obstetricians and Gynecologists. Vaginal birth after previous cesarean delivery. Practice bulletin no. 115. Obstet Gynecol 2010; 116 (2 Pt 1): 450–463.
Macones GA, Peipert J, Nelson DB, Odibo A, Stevens EJ, Stamilio DM et al. Maternal complications with vaginal birth after cesarean delivery: a multicenter study. Am J Obstet Gynecol 2005; 193 (5): 1656–1662.
Fitzpatrick KE, Kurinczuk JJ, Alfirevic Z, Spark P, Brocklehurst P, Knight M . Uterine rupture by intended mode of delivery in the UK: a national case-control study. PLos Med 2012; 9 (3): e101184.
Juhasz G, Gyamfi C, Gyamfi P, Tocce K, Stone JL . Effect of body mass index and excessive weight gain on success of vaginal birth after cesarean delivery. Obstet Gynecol 2005; 106 (4): 741–746.
Chauhan SP, Magann EF, Carroll CS, Barrilleaux PS, Scardo JA, Martin JN Jr . Mode of delivery for the morbidly obese with prior cesarean delivery: vaginal versus repeat cesarean section. Am J Obstet Gynecol 2001; 185 (2): 349–354.
Carroll CS Sr, Magann EF, Chauhan SP, Klauser CK, Morrison JC . Vaginal birth after cesarean section versus elective repeat cesarean delivery: weight-based outcomes. Am J Obstet Gynecol 2003; 188 (6): 1516–1520.
Hibbard JU, Gilbert S, Landon MB, Hauth JC, Leveno KJ, Spong CY et al. Trial of labor or repeat cesarean delivery in women with morbid obesity and previous cesarean delivery. Obstet Gynecol 2006; 108 (1): 125–133.
Durnwald CP, Ehrenberg HM, Mercer BM . The impact of maternal obesity and weight gain on vaginal birth after cesarean section success. Am J of Obstetrics Gynecol 2004; 191 (3): 954–957.
Landon M, Leindecker S, Spong CY, Hauth JC, Bloom S, Varner MW et al. The MFM Cesarean Registry: Factors affecting the success of trial of labor after previous cesarean delivery. Am J of Obstet Gynecol 2005; 193 (3 Pt 2): 1016–1023.
Shanks AL, Cahill AG . Delivery after prior cesarean: success rate and factors. Clin Perinatol 2011; 38 (2): 233–245.
Srinivas SK, Stamilio DM, Stevens EJ, Peipert JF, Odibo AO, Macones GA et al. Safety and success of vaginal birth After cesarean delivery in patients with preeclampsia. Am J Perinatol 2006; 23 (3): 145–152.
Blackwell SC, Hassan SS, Wolfe HM, Michaelson J, Berry SM, Sorokin Y et al. Vaginal birth after cesarean in the diabetic gravida. J Reprod Med. 2000; 45 (12): 987–990.
Dharan VB, Sk Srinivas, Parry S, Ratcliffe SJ, Macones G . Pregestational diabetes: a risk factor for vaginal birth after cesarean section failure? Am J Perinatol 2010; 27 (3): 265–270.
Cormier DM, Landon MB, Lai Y, Spong CY, Rouse DJ, Leveno KJ et al. White’s classification of maternal diabetes and vaginal birth after cesarean delivery success in women undergoing a trial of labor. Obstet Gynecol 2010; 115 (1): 60–64.
Durnwald C, Mercer B . Vaginal birth after cesarean delivery: predicting success, risk of failure. J Matern Fetal Neonatal Med 2004; 15 (6): 388–393.
Ehrenberg HM . Intrapartum considerations in prenatal care. Semin Perinatal 2011; 35 (6): 324–329.
Rosen MG, Dickinson JC . Vaginal birth after cesarean: a meta-analysis for success. Obstet Gynecol 1990; 76 (5 Pt 1): 865–869.
Guise JM, Berlin M, McDonagh M, Osterweil P, Chan B, Helfand M et al. Safety of vaginal birth after cesarean: a systemic review. Obstet Gynecol 2004; 103 (3): 420–429.
Madaan M, Agrawal S, Nigam A, Aggarwal R, Trivedi SS . Trial of labour after previous caesarean section: the predictive factors affecting outcome. J Obstet Gynaecol 2011; 31 (3): 224–228.
Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines Rasmussen KM, Yaktine AL . Weight Gain During Pregnancy: Reexamining the Guidelines. National Academies Press: Washington, DC, USA, 2009.
Grimes DA . Epidemiologic research using administrative databases: garbage in, garbage out. Obstet Gynecol. 2010; 116 (5): 1018–1019.
Ananth CV . Perinatal epidemiologic research with vital statistics data: validity is the essential quality. Am J Obstet Gynecol 2005; 193 (1): 5–6.
Reichman NE, Schwartz-Soiche O . Accuracy of birth certificate data by risk factors and outcomes: analysis of data from New Jersey. Am J Obstet Gynecol 2007; 197 (1): 32 e1–32 e8.
Lydon-Rochelle MT, Holt VL, Cardenas V, Nelson JC, Easterling TR, Gardella C et al. The reporting of pre-existing maternal medical conditions and complications of pregnancy on birth certificates and in hospital discharge data. Am J Obstet Gynecol 2005; 193 (1): 125–134.
Bailit JL . Rates of labor induction without medical indication are overestimated when derived from birth certificate data. Am J Obstet Gynecol 2010; 203 (3): 269e1–3.
Reichman NE, Hade EM . Validation of birth certificate data. A study of women in New Jersey's HealthStart program. Ann Epidemiol 2001; 11 (3): 186–193.
Emery ES, Eaton A, Grether JK, Nelson KB . Assessment of gestational age using birth certificate data compared with medical record data. Paediatr Perinat Epidemiol 1997; 11 (3): 313–321.
Piper JM, Matchel EF Jr, Snowden M, Hall C, Adams M, Taylor P . Validation of 1989 Tennessee birth certificates using maternal and newborn hospital records. Am J Epidemiol 1993; 137 (7): 758–768.
Grobman WA, Lai Y, Landon MB, Spong CY, Leveno KJ, Rouse DJ et al. National Institute of Child Health and Human Development (NICHD) Materal Fetal Medicine Units Network (MFMU). Development of a nomogram for prediction of vaginal birth after cesarean delivery. Obstet Gynecol 2007; 109 (4): 806–812.
Grobman WA, Lai Y, Landon MB, Spong CY, Leveno KJ, Rouse DJ et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Can a prediction model for vaginal birth after cesarean also predict the probability of morbidity related to a trial of labor? Am J Obstet Gynecol 2009; 200: e1–e6.
Grobman WA . Rates and prediction of successful vaginal birth after cesarean. Semin Perinatol. 2010; 34 (4): 244–248.
Grobman WA, Lai YL, Landon MB, Spong CY, Leveno KJ, Rouse DJ et al. Does information available at admission for delivery improve prediction of vaginal birth after cesarean? Am J Perinatol 2009; 26 (10): 693–701.
Costantine MM, Fox K, Byers BD, Mateus J, Ghulmiyyah LM, Blackwell S et al. Validation of the prediction model for success of vaginal birth after cesarean delivery. Obstet Gynecol 2009; 114 (5): 1029–1033.
Blackwell SC . Predicting VBAC success: from theory to clinical practice. Am J Perinatol 2009; 26 (10): 691–692.
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.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
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.
Rights and permissions
About this article
Cite this article
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
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/jp.2014.196
This article is cited by
-
Sonographic fetal head circumference is associated with trial of labor after cesarean section success
Archives of Gynecology and Obstetrics (2022)
-
Prediction of successful preterm vaginal birth after cesarean among women who never delivered vaginally
Archives of Gynecology and Obstetrics (2022)
-
Trial of labor after cesarean in women with hypertensive disorders and no prior vaginal delivery
Archives of Gynecology and Obstetrics (2022)
-
Factors associated with successful vaginal birth after a cesarean section: a systematic review and meta-analysis
BMC Pregnancy and Childbirth (2019)
-
Trial of labor after cesarean in the low-risk obstetric population: a retrospective nationwide cohort study
Journal of Perinatology (2016)