Rietveld A L, Teunissen P W, Kazemier B M, De Groot C J M
Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands.
School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands.
J Perinatol. 2017 Nov;37(11):1192-1196. doi: 10.1038/jp.2017.117. Epub 2017 Aug 31.
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.
本研究旨在探讨剖宫产术后再次妊娠间隔时间与剖宫产术后阴道分娩成功率之间的关联。
对有一次剖宫产史且选择阴道试产的孕妇进行为期10年的回顾性队列研究（n = 36653）。再次妊娠间隔时间是指剖宫产与下次受孕之间的时间。比较了六个间隔时间组的阴道分娩成功率。对引产进行了汇总分析和分层分析。计算了调整后的优势比。
参照组（12至24个月）的成功率为72%。间隔时间少于24个月的人群成功率相似。间隔时间为24个月及以上的成功率降低；24至35个月间隔时间的成功率为70%（调整后的优势比为0.92（0.87至0.98）），36至59个月间隔时间的成功率为67%（调整后的优势比为0.87（0.81至0.94）），间隔时间超过60个月的成功率为62%（调整后的优势比为0.77（0.67至0.88））。
再次妊娠间隔时间<24个月与剖宫产术后阴道分娩成功率降低无关。间隔时间增加时成功率降低。
