Characteristics of women who underwent one or more previous cesarean sections according to Nascer no Brasil
ABSTRACT OBJECTIVE To descriptively analyze Brazilian parturient women who underwent previous cesarean section and point out the factors associated with Vaginal Birth After Cesarean (VBAC) in Brazil. METHODS The study used data from women with one, two, or three or more cesarean sections from th...
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| Format: | Article |
| Language: | English |
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Universidade de São Paulo
2023-11-01
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| Series: | Revista de Saúde Pública |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102023000100275&lng=en&tlng=en |
| _version_ | 1797628702592335872 |
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| author | Marina Barreto Alvarenga Silvana Granado Nogueira da Gama Marcos Nakamura-Pereira |
| author_facet | Marina Barreto Alvarenga Silvana Granado Nogueira da Gama Marcos Nakamura-Pereira |
| author_sort | Marina Barreto Alvarenga |
| collection | DOAJ |
| description | ABSTRACT OBJECTIVE To descriptively analyze Brazilian parturient women who underwent previous cesarean section and point out the factors associated with Vaginal Birth After Cesarean (VBAC) in Brazil. METHODS The study used data from women with one, two, or three or more cesarean sections from the survey Nascer no Brasil (Birth in Brazil). Differences between categories were assessed through the chi-square test (χ2). Variables with significant differences (p < 0.05) were incorporated into logistic regression. FINDINGS Out of the total of 23,894 women, 20.9% had undergone a previous cesarean section. The majority (85.1%) underwent another cesarean section, with 75.5% occurring before the onset of labor. The rate of Vaginal Birth After Cesarean (VBAC) was 14.9%, with a success rate of 60.8%. Women who underwent three or more cesarean sections displayed greater social vulnerability. The chances of VBAC were higher among those who opted for a vaginal birth towards the end of gestation, had a prior vaginal birth, underwent labor induction, were admitted with over 4 centimeters of dilation, and without partner. Receiving care from the private health care system, having two or more prior cesarean sections, obstetric complications, and deciding on cesarean delivery late in gestation reduced the chances of VBAC. Age group, educational background, prenatal care adequacy, and the reason for the previous cesarean section did not result in significant differences. CONCLUSION The majority of women who underwent a previous cesarean section in Brazil are directed towards another surgery, and a higher number of cesarean sections is linked to greater social inequality. Factors associated with VBAC included choosing vaginal birth towards the end of gestation, having had a previous vaginal birth, higher cervical dilation upon admission, induction, assistance from the public health care system, absence of obstetric complications, and without a partner. Efforts to promote VBAC are necessary to reduce overall cesarean rates and their repercussions on maternal and child health. |
| first_indexed | 2024-03-11T10:43:47Z |
| format | Article |
| id | doaj.art-330849bfa635473db0b07c42d8bd9d03 |
| institution | Directory Open Access Journal |
| issn | 1518-8787 |
| language | English |
| last_indexed | 2024-03-11T10:43:47Z |
| publishDate | 2023-11-01 |
| publisher | Universidade de São Paulo |
| record_format | Article |
| series | Revista de Saúde Pública |
| spelling | doaj.art-330849bfa635473db0b07c42d8bd9d032023-11-14T07:50:06ZengUniversidade de São PauloRevista de Saúde Pública1518-87872023-11-015710.11606/s1518-8787.2023057004819Characteristics of women who underwent one or more previous cesarean sections according to Nascer no BrasilMarina Barreto Alvarengahttps://orcid.org/0000-0003-1133-1924Silvana Granado Nogueira da Gamahttps://orcid.org/0000-0002-9200-0387Marcos Nakamura-Pereirahttps://orcid.org/0000-0002-4231-0205ABSTRACT OBJECTIVE To descriptively analyze Brazilian parturient women who underwent previous cesarean section and point out the factors associated with Vaginal Birth After Cesarean (VBAC) in Brazil. METHODS The study used data from women with one, two, or three or more cesarean sections from the survey Nascer no Brasil (Birth in Brazil). Differences between categories were assessed through the chi-square test (χ2). Variables with significant differences (p < 0.05) were incorporated into logistic regression. FINDINGS Out of the total of 23,894 women, 20.9% had undergone a previous cesarean section. The majority (85.1%) underwent another cesarean section, with 75.5% occurring before the onset of labor. The rate of Vaginal Birth After Cesarean (VBAC) was 14.9%, with a success rate of 60.8%. Women who underwent three or more cesarean sections displayed greater social vulnerability. The chances of VBAC were higher among those who opted for a vaginal birth towards the end of gestation, had a prior vaginal birth, underwent labor induction, were admitted with over 4 centimeters of dilation, and without partner. Receiving care from the private health care system, having two or more prior cesarean sections, obstetric complications, and deciding on cesarean delivery late in gestation reduced the chances of VBAC. Age group, educational background, prenatal care adequacy, and the reason for the previous cesarean section did not result in significant differences. CONCLUSION The majority of women who underwent a previous cesarean section in Brazil are directed towards another surgery, and a higher number of cesarean sections is linked to greater social inequality. Factors associated with VBAC included choosing vaginal birth towards the end of gestation, having had a previous vaginal birth, higher cervical dilation upon admission, induction, assistance from the public health care system, absence of obstetric complications, and without a partner. Efforts to promote VBAC are necessary to reduce overall cesarean rates and their repercussions on maternal and child health.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102023000100275&lng=en&tlng=enDelivery, ObstetricVaginal Birth After CesareanNatural ChildbirthCesarean SectionMaternal Health |
| spellingShingle | Marina Barreto Alvarenga Silvana Granado Nogueira da Gama Marcos Nakamura-Pereira Characteristics of women who underwent one or more previous cesarean sections according to Nascer no Brasil Revista de Saúde Pública Delivery, Obstetric Vaginal Birth After Cesarean Natural Childbirth Cesarean Section Maternal Health |
| title | Characteristics of women who underwent one or more previous cesarean sections according to Nascer no Brasil |
| title_full | Characteristics of women who underwent one or more previous cesarean sections according to Nascer no Brasil |
| title_fullStr | Characteristics of women who underwent one or more previous cesarean sections according to Nascer no Brasil |
| title_full_unstemmed | Characteristics of women who underwent one or more previous cesarean sections according to Nascer no Brasil |
| title_short | Characteristics of women who underwent one or more previous cesarean sections according to Nascer no Brasil |
| title_sort | characteristics of women who underwent one or more previous cesarean sections according to nascer no brasil |
| topic | Delivery, Obstetric Vaginal Birth After Cesarean Natural Childbirth Cesarean Section Maternal Health |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102023000100275&lng=en&tlng=en |
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