title: Elective repeat cesarean delivery compared with trial of labor after a prior cesarean delivery: a propensity score analysis.
abstract: OBJECTIVE
  To determine neonatal and short term maternal outcomes according to intentional mode of delivery following a cesarean delivery (CD).
  
  
  METHODS
  Women pregnant after CD between January 2000 and December 2007 were categorized according to whether they had an elective repeat CD (ERCD) or a Trial of Labor (TOL). Prognostically equal ERCD and TOL groups were created using the propensity score matching technique. Conditional logistic regression was performed to assess differences in neonatal and maternal outcomes.
  
  
  METHODS
  Women in their second ongoing pregnancy with a history of CD.
  
  
  RESULTS
  After ERCD the rates of low 5min Apgar score (OR 0.3, 95%CI 0.2-0.5, p<0.001), meconium aspiration (OR 0.0, 95%CI 0-0.7, p=0.02) and birth trauma (OR 0.08, 95%CI 0.002-0.5, p<0.001) were lower compared to TOL. The rate of transient tachypnoea of the newborn (TTN) appears higher in the ERCD group (OR 1.7, 95%CI 1.0-2.8, p=0.04). Uterine rupture (OR 0.1, 95%CI 0.003-0.8, p=0.02) and hemorrhage (OR 0.6, 95%CI 0.5-0.8, p<0.001) occurred less in the ERCD group.
  
  
  CONCLUSIONS
  Neonatal and short term maternal morbidity appears to be lower after ERCD than after TOL. Only TTN was seen more often after ERCD.
authors.affiliation: Department of Obstetrics and Gynecology, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: N.kok1@vumc.nl.
authors.forename: N
authors.initials: N
authors.lastname: Kok
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam, The Netherlands. Electronic address: L.Ruiter@amc.uva.nl.
authors.forename: L
authors.initials: L
authors.lastname: Ruiter
authors.affiliation: Department of Clinical Epidemiology, Academic Medical Centre, Amsterdam, The Netherlands. Electronic address: R.Lindeboom@amc.uva.nl.
authors.forename: R
authors.initials: R
authors.lastname: Lindeboom
authors.affiliation: Department of Obstetrics and Gynecology, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: Cj.degroot@vumc.nl.
authors.forename: C
authors.initials: C
authors.lastname: de Groot
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam, The Netherlands. Electronic address: E.Pajkrt@amc.uva.nl.
authors.forename: E
authors.initials: E
authors.lastname: Pajkrt
authors.affiliation: The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia. Electronic address: Ben.mol@adelaide.edu.au.
authors.forename: B W
authors.initials: BW
authors.lastname: Mol
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam, The Netherlands. Electronic address: B.M.Kazemier@amc.uva.nl.
authors.forename: B M
authors.initials: BM
authors.lastname: Kazemier
mesh_terms: D000328:Adult; D001034:Apgar Score; D001720:Birth Injuries / Q000453:epidemiology; D017604:Cesarean Section, Repeat / Q000009:adverse effects / Q000706:statistics & numerical data*; D015331:Cohort Studies; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008471:Meconium Aspiration Syndrome / Q000453:epidemiology; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D057216:Propensity Score; D011446:Prospective Studies; D059245:Transient Tachypnea of the Newborn / Q000453:epidemiology; D014219:Trial of Labor; D014597:Uterine Rupture / Q000453:epidemiology; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects / Q000706:statistics & numerical data*
keywords: Adverse neonatal outcomes; Elective repeat cesarean delivery (ERCD); Propensity score matching; Trial of labor (TOL); Vaginal birth after cesarean delivery (VBAC)