The objective of this study is to investigate the association between interpregnancy interval and success of vaginal birth after cesarean.
Retrospective 10-year cohort study of pregnant women with one prior cesarean, who opted for trial of labor (n=36 653). Interpregnancy interval is the time between cesarean and next conception. Vaginal birth success rates were compared between six interval groups. Analysis was performed pooled as well as stratified for induction of labor. Adjusted odds ratios were calculated.
Success rate in the reference group (12 to 24 months) was 72%. Success rates were similar among those with an interval of less than 24 months. Intervals of 24 months or more showed a decrease in success rate; 70% in 24- to 35-month intervals (adjusted odds ratio 0.92 (0.87 to 0.98)), 67% in 36- to 59-month intervals (adjusted odds ratio 0.87 (0.81 to 0.94)) and 62% in intervals of more than 60 months (adjusted odds ratio 0.77 (0.67 to 0.88)).
An interpregnancy interval of <24 months is not associated with a decreased success of vaginal birth after cesarean. Success rates decrease when interval increases.
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Hamilton BE, Martin JA, Osterman MJK, Curtin SC . Births: Preliminary Data for 2014. Natl Vital Stat Rep 2015; 64: 1–19.
Mozurkewich EL, Hutton EK . Elective repeat cesarean delivery versus trial of labor: a meta-analysis of the literature from 1989 to 1999. Am J Obstet Gynecol 2000; 183: 1187–1197.
Hook B, Kiwi R, Amini SB, Fanaroff A, Hack M . Neonatal morbidity after elective repeat cesarean section and trial of labor. Pediatrics 1997; 100: 348–353.
Moody J ed. Caesarean Section, Clinical Guideline. RCOG Press: London, 2004.
Guise J-M, Eden K, Emeis C, Denman MA, Marshall N, Fu R et al. Vaginal birth after cesarean: new insights. Evid Rep Technol Assess (Full Rep) 2010; 191: 1–397.
Grobman WA, Lai Y, Landon MB, Spong CY . Development of a nomogram for prediction of vaginal birth after cesarean delivery. Obstet Gynecol 2007; 109: 806–812.
Jastrow N, Roberge S, Gauthier RJ, Laroche L, Duperron L, Brassard N et al. Effect of birth weight on adverse obstetric outcomes in vaginal birth after cesarean delivery. Obstet Gynecol 2010; 115: 338–343.
The American Congress of Obstetricians and Gynecologists. ACOG practice bulletin no. 115: vaginal birth after previous cesarean delivery. Obstet Gynecol 2010; 116: 450–463.
Nederlandse Vereniging voor Obstetrie en Gynaecologie. Zwangerschap en Bevalling na een Voorgaande Sectio Caesarea. (Guideline Pregnancy and Delivery after a Previous Cesarean Section of the Dutch Society of Obstetrics and Gynaecology) 2010, www.nvog.nl.
Huang WH, Nakashima DK, Rumney PJ, Keegan KA Jr, Chan K . Interdelivery interval and the success of vaginal birth after cesarean delivery. Obstet Gynecol 2002; 99: 41–44.
Landon MB, Leindecker S, Spong CY, Hauth JC, Bloom S, Varner MW et al. The MFMU Cesarean Registry: factors affecting the success of trial of labor after previous cesarean delivery. Am J Obstet Gynecol 2005; 193 (Suppl 3): 1016–1023.
Méray N, Reitsma JB, Ravelli ACJ, Bonsel GJ . Probabilistic record linkage is a valid and transparent tool to combine databases without a patient identification number. J Clin Epidemiol 2007; 60: 883–891.
Tromp M, Ravelli ACJ, Méray N, Reitsma JB, Bonsel GJ . An efficient validation method of probabilistic record linkage including readmissions and twins. Methods Inf Med 2008; 47: 356–363.
Stichting Perinatale Registratie Nederland Perinatale zorg in Nederland 2007 (Perinatal Care in the Netherlands 2007). Stichting Perinatale Registratie Nederland: Utrecht, 2009.
Schaaf JM, Hof MHP, Mol BWJ, Abu-Hanna A, Ravelli ACJ . Recurrence risk of preterm birth in subsequent singleton pregnancy after preterm twin delivery. Am J Obstet Gynecol 2012; 207: 279.e1–279.e7.
Zwart JJ, Richters JM, Ory F, de Vries JIP, Bloemenkamp KWM, van Roosmalen J . Uterine rupture in The Netherlands: a nationwide population-based cohort study. BJOG 2009; 116: 1069–78-80.
Al-Zirqi I, Kjersti Daltveit A, Forsén L, Stray-Pedersen B, Vangen S . Risk factors for complete uterine rupture. Am J Obstet Gynecol 2017; 216: 165.e1–165.e8.
MacDorman M, Declercq E, Menacker F . Recent trends and patterns in cesarean and vaginal birth after cesarean (VBAC) deliveries in the United States. Clin Perinatol 2011; 38: 179–192.
Grimes DA, Schulz KF . False alarms and pseudo-epidemics: the limitations of observational epidemiology. Obstet Gynecol 2012; 120: 920–927.
Rijksinstituut voor Volksgezondheid en Milieu (RIVM). Measuring the Netherlands. A monitoring study of risk factors in the general population, 2009–2010. 2011 www.rivm.nl.
We thank all Dutch perinatal health-care professionals for registration of perinatal information. We thank the Foundation of the PRN (www.perinatreg.nl) for permission to use the registry data (registration number 15.41). No financial support or funding was received.
The authors declare no conflict of interest.
Supplementary Information accompanies the paper on the Journal of Perinatology website
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Rietveld, A., Teunissen, P., Kazemier, B. et al. Effect of interpregnancy interval on the success rate of trial of labor after cesarean. J Perinatol 37, 1192–1196 (2017). https://doi.org/10.1038/jp.2017.117
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