title: Prior cesarean section is associated with increased preeclampsia risk in a subsequent pregnancy.
abstract: BACKGROUND
  To evaluate the impact of a prior cesarean section on preeclampsia risk in a subsequent pregnancy.
  
  
  METHODS
  Study data were collected from the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service for 2006-2010. Patients who had their first delivery in 2006 and subsequent delivery between 2007 and 2010 in Korea were enrolled. The overall incidence of preeclampsia during the second pregnancy was estimated and to evaluate the risk of preeclampsia in the second pregnancy, a model of multivariate logistic regression analysis was performed with preeclampsia as the final outcome
  
  
  RESULTS
  The risk of preeclampsia in any pregnancy was 2.17%; the risk in the first pregnancy was 2.76%, and that in the second pregnancy was 1.15%. During the second pregnancy, the risk of preeclampsia was 13.30% for women who had developed preeclampsia in their first pregnancy and 0.85% for those who had not. In the entire population, prior cesarean section was associated with preeclampsia risk in their subsequent pregnancy (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.13-1.41). Among women with and without preeclampsia in their first pregnancy, a prior cesarean section was associated with preeclampsia risk in their second pregnancy (OR, 1.35; 95% CI, 1.09-1.67; OR, 1.23; 95% CI, 1.08-1.40, respectively).
  
  
  CONCLUSIONS
  Our study showed that cesarean section in a first pregnancy was associated with increased preeclampsia risk in the second pregnancy. These results provide physicians with a preeclampsia risk evaluation method for a second pregnancy that they may aid counseling in patients.
authors: Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. md_cho@hanmail.net.
authors: Geum Joon
authors: GJ
authors: Cho
authors: The Health Insurance Review and Assessment Service of Korea, Seoul, Korea. logy@hira.or.kr.
authors: Log Young
authors: LY
authors: Kim
authors: Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. mikji@naver.com.
authors: Kyung-Jin
authors: KJ
authors: Min
authors: The Health Insurance Review and Assessment Service of Korea, Seoul, Korea. yena@hira.or.kr.
authors: Ye Na
authors: YN
authors: Sung
authors: Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. schong@korea.ac.kr.
authors: Soon-Cheol
authors: SC
authors: Hong
authors: Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. mjohmd@korea.ac.kr.
authors: Min-Jeong
authors: MJ
authors: Oh
authors: Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. hsseo@korea.ac.kr.
authors: Hong-Seog
authors: HS
authors: Seo
authors: Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. haijkim@korea.ac.kr.|The Health Insurance Review and Assessment Service of Korea, Seoul, Korea. haijkim@korea.ac.kr.
authors: Hai-Joong
authors: HJ
authors: Kim
mesh_terms: D000328:Adult; D001721:Birth Intervals; D002585:Cesarean Section / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D016017:Odds Ratio; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors