The association of maternal age and symptomatic uterine rupture during a trial of labor after prior cesarean delivery.
OBJECTIVE
To estimate whether maternal age is associated with a symptomatic uterine rupture during a trial of labor after prior cesarean delivery.


METHODS
We retrospectively reviewed the medical records of all patients undergoing a trial of labor after prior cesarean delivery over a 12-year period. We analyzed the labors of women with one prior cesarean and no prior vaginal deliveries. The uterine rupture rate was determined with respect to maternal age. Multiple logistic regression was used to control for potential confounding variables.


RESULTS
Overall, 32 (1.1%) uterine ruptures occurred among 3015 women. For women younger than 30 years, the risk of uterine rupture was 0.5%, and for those women aged at least 30 years, the risk of uterine rupture was 1.4% (P =.02). Controlling for birth weight, induction, augmentation, and interdelivery interval, the odds ratio for symptomatic uterine rupture for women aged at least 30 years compared with those less than 30 years was 3.2 (95% confidence interval 1.2, 8.4).


CONCLUSIONS
Women aged 30 years or older have a greater risk of uterine rupture as compared with women younger than 30 years.
Shipp
Thomas D
TD
Department of Obstetrics and Gynecology Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. tshipp@partners.org
Zelop
Carolyn
C
Repke
John T
JT
Cohen
Amy
A
Caughey
Aaron B
AB
Lieberman
Ellice
E
D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D016015:Logistic Models; D008423:Maternal Age; D016017:Odds Ratio; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D012189:Retrospective Studies; D018570:Risk Assessment; D014219:Trial of Labor; D014597:Uterine Rupture / Q000453:epidemiology*