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Do They Stand a Chance? Vaginal Birth after Cesarean Section in Adolescents Compared to Adult Women.

MedStar author(s):

Citation: Journal of Pediatric & Adolescent Gynecology. 28(4):219-23, 2015 Aug.PMID: 26024936Institution: MedStar Health Research Institute | MedStar Washington Hospital Center | MedStar Washington Hospital Center | MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology | Obstetrics and Gynecology, Maternal-Fetal Medicine | Obstetrics and Gynecology/Pediatric and AdolescentForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter Study | Research Support, N.I.H., Extramural | Research Support, N.I.H., IntramuralSubject headings: *Cesarean Section/sn [Statistics & Numerical Data] | *Trial of Labor | *Vaginal Birth after Cesarean/sn [Statistics & Numerical Data] | Adolescent | Adult | Body Mass Index | Female | Gestational Age | Humans | Pregnancy | Retrospective Studies | United States | Young AdultYear: 2015 Local holdings: Available online through MWHC library: 2002 - presentISSN:

1083-3188

Name of journal: Journal of pediatric and adolescent gynecologyAbstract: CONCLUSIONS: Adolescents are more likely to attempt VBAC and are likely to be as successful as their adult counterparts. Adolescents should be encouraged to attempt a trial of labor after prior CD when appropriate to lower the risks of lifelong maternal morbidity from numerous repeat CDs.Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.DESIGN: Retrospective cohort study analyzing data from the Consortium on Safe Labor Database which includes data for 228,668 deliveries from 2002 to 2008.METHODS: The database was accessed for information on patient characteristics, prenatal comorbidities, and delivery data. Rates of repeat CD, VBAC attempt, and VBAC success were calculated. Multiple logistic regression was applied to identify predictors of VBAC success.PARTICIPANTS: 10,791 women age < 35 (428 adolescents, age < 19 and 10,363 adults age 20-35) with history of prior CD presenting for delivery of a second child.RESULTS: Adolescents had a lower overall repeat CD rate and higher VBAC attempt rate compared to adults (80.61% vs 85.32%, P = .0072; 40.42% vs 30.09%, P < .0001 respectively). VBAC success was similar between adolescents and adults (47.98% vs 48.78% P = .8368). Delivery at a teaching hospital and greater gestational age were predictive of VBAC success. Gestational diabetes mellitus, induction of labor, and higher maternal body mass index were predictive of VBAC failure. Adolescence was not an independent predictor of VBAC outcome.SETTING: 19 hospitals within 12 institutions in the United States.STUDY OBJECTIVE: To determine the rate of elective repeat cesarean delivery (CD), vaginal birth after cesarean (VBAC) attempt, and VBAC success in adolescent mothers presenting for delivery of a second child after a prior CD compared to their adult counterparts.All authors: Damle LF, Gomez-Lobo V, Huang CC, Landy HJ, Wilson KFiscal year: FY2016Digital Object Identifier:

http://dx.doi.org/10.1016/j.jpag.2014.07.010

Date added to catalog: 2016-05-24

Holdings ( 1 )
Title notes ( 9 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	26024936	Available		26024936

Available online through MWHC library: 2002 - present

CONCLUSIONS: Adolescents are more likely to attempt VBAC and are likely to be as successful as their adult counterparts. Adolescents should be encouraged to attempt a trial of labor after prior CD when appropriate to lower the risks of lifelong maternal morbidity from numerous repeat CDs.Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

DESIGN: Retrospective cohort study analyzing data from the Consortium on Safe Labor Database which includes data for 228,668 deliveries from 2002 to 2008.

METHODS: The database was accessed for information on patient characteristics, prenatal comorbidities, and delivery data. Rates of repeat CD, VBAC attempt, and VBAC success were calculated. Multiple logistic regression was applied to identify predictors of VBAC success.

PARTICIPANTS: 10,791 women age < 35 (428 adolescents, age < 19 and 10,363 adults age 20-35) with history of prior CD presenting for delivery of a second child.

RESULTS: Adolescents had a lower overall repeat CD rate and higher VBAC attempt rate compared to adults (80.61% vs 85.32%, P = .0072; 40.42% vs 30.09%, P < .0001 respectively). VBAC success was similar between adolescents and adults (47.98% vs 48.78% P = .8368). Delivery at a teaching hospital and greater gestational age were predictive of VBAC success. Gestational diabetes mellitus, induction of labor, and higher maternal body mass index were predictive of VBAC failure. Adolescence was not an independent predictor of VBAC outcome.

SETTING: 19 hospitals within 12 institutions in the United States.

STUDY OBJECTIVE: To determine the rate of elective repeat cesarean delivery (CD), vaginal birth after cesarean (VBAC) attempt, and VBAC success in adolescent mothers presenting for delivery of a second child after a prior CD compared to their adult counterparts.

English