Factors associated with successful vaginal birth after a cesarean section: a systematic review and meta-analysis
Abstract Background Evidence for the relationship between maternal and perinatal factors and the success of vaginal birth after cesarean section (VBAC) is conflicting. We aimed to systematically analyze published data on maternal and fetal factors for successful VBAC. Methods A comprehensive search...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-10-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12884-019-2517-y |
| _version_ | 1819144584756723712 |
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| author | Yanxin Wu Yachana Kataria Zilian Wang Wai-Kit Ming Christina Ellervik |
| author_facet | Yanxin Wu Yachana Kataria Zilian Wang Wai-Kit Ming Christina Ellervik |
| author_sort | Yanxin Wu |
| collection | DOAJ |
| description | Abstract Background Evidence for the relationship between maternal and perinatal factors and the success of vaginal birth after cesarean section (VBAC) is conflicting. We aimed to systematically analyze published data on maternal and fetal factors for successful VBAC. Methods A comprehensive search of Medline, Embase, and the Cumulative Index to Nursing and Allied Health Literature, from each database’s inception to March 16, 2018. Observational studies, identifying women with a trial of labor after one previous low-transverse cesarean section were included. Two reviewers independently abstracted the data. Meta-analysis was performed using the random-effects model. Risk of bias was assessed by the Newcastle-Ottawa Scale. Results We included 94 eligible observational studies (239,006 pregnant women with 163,502 VBAC). Factors were associated with successful VBAC with the following odds ratios (OR;95%CI): age (0.92;0.86–0.98), obesity (0.50;0.39–0.64), diabetes (0.50;0.42–0.60), hypertensive disorders complicating pregnancy (HDCP) (0.54;0.44–0.67), Bishop score (3.77;2.17–6.53), labor induction (0.58;0.50–0.67), macrosomia (0.56;0.50–0.64), white race (1.39;1.26–1.54), previous vaginal birth before cesarean section (3.14;2.62–3.77), previous VBAC (4.71;4.33–5.12), the indications for the previous cesarean section (cephalopelvic disproportion (0.54;0.36–0.80), dystocia or failure to progress (0.54;0.41–0.70), failed induction (0.56;0.37–0.85), and fetal malpresentation (1.66;1.38–2.01)). Adjusted ORs were similar. Conclusions Diabetes, HDCP, Bishop score, labor induction, macrosomia, age, obesity, previous vaginal birth, and the indications for the previous CS should be considered as the factors affecting the success of VBAC. |
| first_indexed | 2024-12-22T12:44:28Z |
| format | Article |
| id | doaj.art-ff20db79aa494a02919e38d6f77cdafc |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-22T12:44:28Z |
| publishDate | 2019-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-ff20db79aa494a02919e38d6f77cdafc2022-12-21T18:25:22ZengBMCBMC Pregnancy and Childbirth1471-23932019-10-0119111210.1186/s12884-019-2517-yFactors associated with successful vaginal birth after a cesarean section: a systematic review and meta-analysisYanxin Wu0Yachana Kataria1Zilian Wang2Wai-Kit Ming3Christina Ellervik4Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen UniversityDepartment of Laboratory Medicine, Boston Children’s Hospital and Harvard Medical SchoolDepartment of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen UniversityDepartment of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen UniversityDepartment of Laboratory Medicine, Boston Children’s Hospital and Harvard Medical SchoolAbstract Background Evidence for the relationship between maternal and perinatal factors and the success of vaginal birth after cesarean section (VBAC) is conflicting. We aimed to systematically analyze published data on maternal and fetal factors for successful VBAC. Methods A comprehensive search of Medline, Embase, and the Cumulative Index to Nursing and Allied Health Literature, from each database’s inception to March 16, 2018. Observational studies, identifying women with a trial of labor after one previous low-transverse cesarean section were included. Two reviewers independently abstracted the data. Meta-analysis was performed using the random-effects model. Risk of bias was assessed by the Newcastle-Ottawa Scale. Results We included 94 eligible observational studies (239,006 pregnant women with 163,502 VBAC). Factors were associated with successful VBAC with the following odds ratios (OR;95%CI): age (0.92;0.86–0.98), obesity (0.50;0.39–0.64), diabetes (0.50;0.42–0.60), hypertensive disorders complicating pregnancy (HDCP) (0.54;0.44–0.67), Bishop score (3.77;2.17–6.53), labor induction (0.58;0.50–0.67), macrosomia (0.56;0.50–0.64), white race (1.39;1.26–1.54), previous vaginal birth before cesarean section (3.14;2.62–3.77), previous VBAC (4.71;4.33–5.12), the indications for the previous cesarean section (cephalopelvic disproportion (0.54;0.36–0.80), dystocia or failure to progress (0.54;0.41–0.70), failed induction (0.56;0.37–0.85), and fetal malpresentation (1.66;1.38–2.01)). Adjusted ORs were similar. Conclusions Diabetes, HDCP, Bishop score, labor induction, macrosomia, age, obesity, previous vaginal birth, and the indications for the previous CS should be considered as the factors affecting the success of VBAC.http://link.springer.com/article/10.1186/s12884-019-2517-yVaginal birth after cesarean sectionTrial of laborDelivery |
| spellingShingle | Yanxin Wu Yachana Kataria Zilian Wang Wai-Kit Ming Christina Ellervik Factors associated with successful vaginal birth after a cesarean section: a systematic review and meta-analysis BMC Pregnancy and Childbirth Vaginal birth after cesarean section Trial of labor Delivery |
| title | Factors associated with successful vaginal birth after a cesarean section: a systematic review and meta-analysis |
| title_full | Factors associated with successful vaginal birth after a cesarean section: a systematic review and meta-analysis |
| title_fullStr | Factors associated with successful vaginal birth after a cesarean section: a systematic review and meta-analysis |
| title_full_unstemmed | Factors associated with successful vaginal birth after a cesarean section: a systematic review and meta-analysis |
| title_short | Factors associated with successful vaginal birth after a cesarean section: a systematic review and meta-analysis |
| title_sort | factors associated with successful vaginal birth after a cesarean section a systematic review and meta analysis |
| topic | Vaginal birth after cesarean section Trial of labor Delivery |
| url | http://link.springer.com/article/10.1186/s12884-019-2517-y |
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