Adverse neonatal outcomes associated with trial of labor after previous cesarean delivery in an inner-city hospital in Lagos, Nigeria.
OBJECTIVE
To identify delivery methods and associated adverse neonatal outcomes after previous cesarean delivery.


METHODS
A retrospective cross-sectional study in an inner-city maternity hospital in Lagos, Nigeria, in which outcomes associated with delivery methods were determined by multinomial logistic regression.


RESULTS
Of 435 eligible singleton deliveries, 171 (39.3%) occurred via elective cesarean, 249 (57.2%) via emergency cesarean, and 15 (3.4%) after successful trial of labor. Emergency cesarean delivery was associated with low 1-minute Apgar scores compared with successful trial of labor. It was also associated with low 5-minute Apgar scores compared with elective cesarean delivery, in addition to hyperbilirubinemia and admission to the special care baby unit. Successful trial of labor was less likely to be associated with low 1-minute Apgar scores than was elective cesarean delivery. The delivery methods were not associated with risk of sensorineural hearing loss.


CONCLUSIONS
Trial of labor is common in this tertiary hospital among women with previous cesarean delivery and is associated with high failure rates and adverse neonatal outcomes with potential developmental risks.
Olusanya
Bolajoko O
BO
Maternal and Child Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria. boolusanya@aol.com
Solanke
Olumuyiwa A
OA
D000328:Adult; D001034:Apgar Score; D017604:Cesarean Section, Repeat / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D006932:Hyperbilirubinemia / Q000209:etiology; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009549:Nigeria; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data*