Factors associated with vaginal birth after previous cesarean section in Brazilian women Factores relacionados con el parto vaginal en mujeres brasileñas con cesárea anterior

• Main Authors: José Guilherme Cecatti, Helaine Maria Besteti Pires, Aníbal Faúndes, Maria José Duarte Osis
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2005
• Subjects: Cesárea; parto vaginal después de cesárea; factores de riesgo; esfuerzo de parto; Cesarean section; vaginal birth after cesarean; risk factors; trial of labor; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doaj.org/article/5fd91ca7e6de4355a093cd20e3b33050

OBJECTIVE: To identify factors associated with a vaginal second delivery in women who had one previous cesarean section. METHODS: A nested case-control study was carried out as a secondary data analysis of an original retrospective, population-based cohort study of women who delivered their first child during 1985 in the city of Campinas, São Paulo, Brazil, and who were interviewed 10 years later in 1995. The study population consisted of 1 352 women who had their first delivery by cesarean section and who had also had at least one subsequent delivery. The group of cases (150 women, around 11% of the sample) consisted of women who had a vaginal second delivery, and the control group was made up of 1 202 women who had a cesarean section at second delivery. For each possible associated factor we calculated the odds ratio and 95% confidence interval. For ordered categorical variables the c² test for trend was used. Unconditional multivariate regression analysis was used to estimate the adjusted odds ratio for each associated factor. RESULTS: The factors significantly associated with vaginal delivery were monthly family income below 5-fold the Brazilian minimum monthly wage, reliance on the Brazilian national health system for healthcare, low maternal age, and first cesarean section indicated because of fetal breech or transverse presentation, or twin pregnancy. Among those women who also had a cesarean section at their second delivery, only 11% had undergone a trial of labor. CONCLUSIONS: The main determining factors for a vaginal second delivery in women with a previous cesarean section were unfavorable social and economic factors. OBJETIVO: Determinar qué factores se asocian con el parto vaginal en mujeres que han tenido una cesárea. MÉTODOS: Un estudio anidado de casos y testigos se llevó a cabo en forma de un análisis de datos secundarios procedentes de un estudio de cohorte -original, retrospectivo y de carácter poblacional- en mujeres que tuvieron su primer hijo en 1985 en la ciudad de Campinas, São Paulo, ...