Golzareh Parvin, Baha Halima, Aram Fahima, Stanikzai Muhammad Haroon, Rabizada Razia, Jafari Massoma
Department of Advanced Midwifery Skills, School of Midwifery, Kabul University of Medical Sciences "Abu Ali Ibn Sina", Kabul, Afghanistan.
Department of Normal Midwifery, School of Midwifery, Kabul University of Medical Sciences "Abu Ali Ibn Sina", Kabul, Afghanistan.
Int J Womens Health. 2025 Jun 6;17:1701-1710. doi: 10.2147/IJWH.S517179. eCollection 2025.
Vaginal Birth After Cesarean delivery (VBAC) is widely regarded as one of the most effective methods to reduce unnecessary Cesarean section and their complications. Despite its proven benefits, data on the success rate of VBAC and the associated factors remain scarce in Afghanistan. This study aimed to address this gap by determining the VBAC success rate and identifying its associated factors in a maternity hospital in Kabul, Afghanistan.
This cross-sectional study was conducted at Malalai Obstetrics and Gynecology Hospital in Kabul, Afghanistan. The study sample included women with a history of previous cesarean section who visited the hospital between March 21 and September 22, 2023. Demographic and clinical information were collected from client files. Descriptive statistics were used to summarize the demographic and clinical characteristics of the study sample. The association between VBAC and various categorical variables were examined using chi-square tests, with a significance level set at < 0.05. Logistic regression analysis was performed to identify independent predictors of VBAC, with VBAC as the outcome variable and multiple predictors included in the model.
Among the 567 women included in the study, 449 (79.2%) had a successful VBAC. Factors associated with successful VBAC and their adjusted odds ratio (95% CI) were lower gestational age: 1.25 (1.05-1.48), absence of gestational hypertension: 2.71 (1.26-5.85), cervical dilation of > 4 cm on admission: 2.77 (1.38-5.55), effacement of ≥ 50% on admission: 2.13 (1.04-4.35), and absence of fetal distress: 7.35 (4.29-12.6).
The rate of successful VBAC observed in this study is at a high level (79.2%). This study is the first study to determine the VBAC success rate and its associated factors in Afghanistan. Further research is needed to validate these findings and explore additional factors influencing VBAC success.
剖宫产术后阴道分娩（VBAC）被广泛认为是减少不必要剖宫产及其并发症的最有效方法之一。尽管其益处已得到证实，但在阿富汗，关于VBAC成功率及其相关因素的数据仍然匮乏。本研究旨在通过确定阿富汗喀布尔一家妇产医院的VBAC成功率并识别其相关因素来填补这一空白。
本横断面研究在阿富汗喀布尔的马拉莱妇产科医院进行。研究样本包括2023年3月21日至9月22日期间到该医院就诊的有剖宫产史的妇女。从客户档案中收集人口统计学和临床信息。使用描述性统计来总结研究样本的人口统计学和临床特征。使用卡方检验检查VBAC与各种分类变量之间的关联，显著性水平设定为<0.05。进行逻辑回归分析以确定VBAC的独立预测因素，以VBAC作为结果变量，并在模型中纳入多个预测因素。
在纳入研究的567名妇女中，449名（79.2%）成功进行了VBAC。与成功VBAC相关的因素及其调整后的优势比（95%CI）为：孕周较低：1.25（1.05 - 1.48），无妊娠期高血压：2.71（1.26 - 5.85），入院时宫颈扩张>4cm：2.77（1.38 - 5.55），入院时宫颈消退≥50%：2.13（1.04 - 4.35），以及无胎儿窘迫：7.35（4.29 - 12.6）。
本研究中观察到的VBAC成功率处于较高水平（79.2%）。本研究是第一项确定阿富汗VBAC成功率及其相关因素的研究。需要进一步研究以验证这些发现并探索影响VBAC成功的其他因素。
