IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0054588.html
   My bibliography  Save this article

Caesarean Delivery and Subsequent Stillbirth or Miscarriage: Systematic Review and Meta-Analysis

Author

Listed:
  • Sinéad M O’Neill
  • Patricia M Kearney
  • Louise C Kenny
  • Ali S Khashan
  • Tine B Henriksen
  • Jennifer E Lutomski
  • Richard A Greene

Abstract

Objective: To compare the risk of stillbirth and miscarriage in a subsequent pregnancy in women with a previous Caesarean or vaginal delivery. Design: Systematic review of the published literature including seven databases: CINAHL; the Cochrane library; Embase; Medline; PubMed; SCOPUS and Web of Knowledge from 1945 until November 11th 2011, using a detailed search-strategy and cross-checking of reference lists. Study Selection: Cohort, case-control and cross-sectional studies examining the association between previous Caesarean section and subsequent stillbirth or miscarriage risk. Two assessors screened titles to identify eligible studies, using a standardised data abstraction form and assessed study quality. Data synthesis: 11 articles were included for stillbirth, totalling 1,961,829 pregnancies and 7,308 events. Eight eligible articles were included for miscarriage, totalling 147,017 pregnancies and 12,682 events. Pooled estimates across the stillbirth studies were obtained using random-effect models. Among women with a previous Caesarean an increase in odds of 1.23 [95% CI 1.08, 1.40] for stillbirth was yielded. Subgroup analyses including unexplained stillbirths yielded an OR of 1.47 [95% CI 1.20, 1.80], an OR of 2.11 [95% CI 1.16, 3.84] for explained stillbirths and an OR of 1.27 [95% CI 0.95, 1.70] for antepartum stillbirths. Only one study reported adjusted estimates in the miscarriage review, therefore results are presented individually. Conclusions: Given the recent revision of the National Institute for Health and Clinical Excellence guidelines (NICE), providing women the right to request a Caesarean, it is essential to establish whether mode of delivery has an association with subsequent risk of stillbirth or miscarriage. Overall, compared to vaginal delivery, the pooled estimates suggest that Caesarean delivery may increase the risk of stillbirth by 23%. Results for the miscarriage review were inconsistent and lack of adjustment for confounding was a major limitation. Higher methodological quality research is required to reliably assess the risk of miscarriage in subsequent pregnancies.

Suggested Citation

  • Sinéad M O’Neill & Patricia M Kearney & Louise C Kenny & Ali S Khashan & Tine B Henriksen & Jennifer E Lutomski & Richard A Greene, 2013. "Caesarean Delivery and Subsequent Stillbirth or Miscarriage: Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-14, January.
    • Handle: RePEc:plo:pone00:0054588
    DOI: 10.1371/journal.pone.0054588
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0054588
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0054588&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0054588?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Halla, Martin & Mayr, Harald & Pruckner, Gerald J. & García-Gómez, Pilar, 2020. "Cutting fertility? Effects of cesarean deliveries on subsequent fertility and maternal labor supply," Journal of Health Economics, Elsevier, vol. 72(C).
    2. Dörthe Brüggmann & Lena-Katharina Löhlein & Frank Louwen & David Quarcoo & Jenny Jaque & Doris Klingelhöfer & David A. Groneberg, 2015. "Caesarean Section—A Density-Equalizing Mapping Study to Depict Its Global Research Architecture," IJERPH, MDPI, vol. 12(11), pages 1-19, November.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0054588. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.