Caesarean or c-section performed in a first pregnancy appears to increase the risk of complications in later pregnancies. To assess possible effects of a caesarean delivery on outcome in subsequent pregnancies, Norwegian researchers analysed 637,497 first and second births among women with two or more single births and 242,812 first, second, and third births among women with three or more single births. It was found that compared to a vaginal first birth, a caesarean delivery at first birth approximately doubled the risk of developing pre-eclampsia, placenta abnormalities, and having a small baby in a second pregnancy. With two prior c-sections, the risk of complications in the third pregnancy was increased, but the odds were similar to those seen after one prior c-section. The researchers also noted that if the same complications were excluded from the first birth, the risks in the second pregnancy fell slightly. This highlights the need of having a good obstetric history. The findings reflect that caesarean delivery is associated with an increased risk of complications in a subsequent pregnancy, but excess risks can be reduced after excluding women with the actual complication in any of their previous deliveries.
Obstetrics & Gynecology
June 2008
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