Titre :

Why women with previous caesarean and eligible for a trial of labour have an elective repeat caesarean delivery? a national study in france

Auteur(s) :

Bartolo, S. [Auteur]
Goffinet, François [Auteur]
Blondel, Béatrice [Auteur]
Deneux-Tharaux, C. [Auteur]

Titre de la revue :

BJOG . an international journal of obstetrics and gynaecology

Nom court de la revue :

BJOG

Numéro :

123

Pagination :

1664-1673

Date de publication :

2016-09-01

ISSN :

1470-0328

Mot(s)-clé(s) en anglais :

Caesarean delivery
route of delivery
repeat caesarean section
previous caesarean
determinants

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

OBJECTIVE: To identify the characteristics of women and maternity units associated with elective repeat caesarean delivery (ERCD) in women eligible for trial of labour after caesarean (TOLAC). METHODS: Cross-sectional ...
Lire la suite >OBJECTIVE: To identify the characteristics of women and maternity units associated with elective repeat caesarean delivery (ERCD) in women eligible for trial of labour after caesarean (TOLAC). METHODS: Cross-sectional study. METHODS: France. METHODS: Using data from the 2010 French National Perinatal Survey, a representative sample of births in France (n = 14 681 women), we studied two groups of women with prior caesarean section: (i) women eligible for TOLAC according to guidelines (n = 1179) and (ii) a subgroup of these women without any medical characteristics that might indicate ERCD (n = 575). METHODS: Associations were analysed by multilevel logistic regression. METHODS: Adjusted odds ratios. RESULTS: Among the 1584 women with a previous caesarean, 1179 (74.4%) were eligible for TOLAC according to guidelines (group 1); 490 (41.6%) had ERCD. Risk of ERCD increased with increasing maternal age and body mass index, pre-existing condition and suspected macrosomia and decreased with previous vaginal deliveries. Among the unit characteristics, private status (aOR = 2.3, 95% CI 1.3-4.1) and low level of care (aOR = 2.5, 95% CI 1.4-4.5]) were independently associated with a higher risk of ERCD after adjustment on patient/pregnancy characteristics. The variability of ERCD rate between hospitals was mainly (78%) explained by the status and level of care, and not (0%) by patient/pregnancy characteristics. Associations with unit characteristics were similar for group 2. CONCLUSIONS: For women eligible for TOLAC, the rate of ERCD is high and not in agreement with guidelines. Some characteristics of women are associated with ERCD, but the main determinants are at the unit level, which suggests that non-medical reasons are involved in the decision process. CONCLUSIONS: Elective repeat caesarean in women eligible for trial of labour mainly depends on maternity unit characteristics.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2019-12-09T18:15:19Z