title: Elective repeat cesarean delivery compared with spontaneous trial of labor after a prior cesarean delivery: a propensity score analysis.
abstract: OBJECTIVE
  The purpose of this study was to determine outcomes, after the use of propensity score techniques, to create balanced groups according to whether a woman undergoes elective repeat cesarean delivery (ERCD) or trial of labor (TOL).
  
  
  METHODS
  Women who were eligible for a TOL with 1 previous low transverse incision were categorized according to whether they underwent an ERCD or TOL. A propensity score technique was used to develop ERCD and TOL groups with comparable baseline characteristics. Outcomes were assessed with conditional logistic regression.
  
  
  RESULTS
  The rates of endometritis, operative injury, respiratory distress syndrome, and newborn infant infection were lower and the rates of hysterectomy and wound complication were higher in the ERCD group.
  
  
  CONCLUSIONS
  Propensity score techniques can be used to generate comparable ERCD and TOL groups. Some types of maternal morbidity (such as hysterectomy) are higher; other types (such as operative injury) are lower in the ERCD group. Although the absolute risk is low, neonatal morbidity appears to be lower in the ERCD group.
authors.affiliation: The George Washington University Biostatistics Center, Washington, DC, USA.
authors.forename: Sharon A
authors.initials: SA
authors.lastname: Gilbert
authors.forename: William A
authors.initials: WA
authors.lastname: Grobman
authors.forename: Mark B
authors.initials: MB
authors.lastname: Landon
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
authors.forename: Dwight J
authors.initials: DJ
authors.lastname: Rouse
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Leveno
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Steve N
authors.initials: SN
authors.lastname: Caritis
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Meis
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
authors.forename: Marshall
authors.initials: M
authors.lastname: Carpenter
authors.forename: Mary J
authors.initials: MJ
authors.lastname: O'Sullivan
authors.forename: Baha M
authors.initials: BM
authors.lastname: Sibai
authors.forename: John M
authors.initials: JM
authors.lastname: Thorp
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ramin
authors.forename: Brian M
authors.initials: BM
authors.lastname: Mercer
mesh_terms: D000328:Adult; D017604:Cesarean Section, Repeat / Q000009:adverse effects / Q000706:statistics & numerical data*; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D004715:Endometriosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000453:epidemiology; D057216:Propensity Score; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D014219:Trial of Labor; D014597:Uterine Rupture / Q000453:epidemiology; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data