دورية أكاديمية
أعرض في EDS

Evaluating the impact of a trial of labor after cesarean section on labor duration: a retrospective cohort study.

التفاصيل البيبلوغرافية
العنوان: Evaluating the impact of a trial of labor after cesarean section on labor duration: a retrospective cohort study.
المؤلفون: Ooba H; Department of Obstetrics and Gynecology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-Ku, Okayama City, 700-8558, Okayama Prefecture, Japan., Maki J; Department of Obstetrics and Gynecology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-Ku, Okayama City, 700-8558, Okayama Prefecture, Japan. jotamaki@okayama-u.ac.jp., Masuyama H; Department of Obstetrics and Gynecology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-Ku, Okayama City, 700-8558, Okayama Prefecture, Japan.
المصدر: BMC pregnancy and childbirth [BMC Pregnancy Childbirth] 2024 Aug 15; Vol. 24 (1), pp. 542. Date of Electronic Publication: 2024 Aug 15.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100967799 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2393 (Electronic) Linking ISSN: 14712393 NLM ISO Abbreviation: BMC Pregnancy Childbirth Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Trial of Labor* , Vaginal Birth after Cesarean*/statistics & numerical data , Propensity Score*, Humans ; Female ; Retrospective Studies ; Pregnancy ; Adult ; Japan ; Time Factors ; Cicatrix/etiology ; Cesarean Section/statistics & numerical data ; Labor, Obstetric ; Cohort Studies
مستخلص: Background: Cesarean section (C-section) rates are increasing globally, and repeated C-sections are associated with increased maternal morbidity. Trial of labor after C-section (TOLAC) is an approach to reduce the recurrence of C-sections. However, limited research exists on the impact of cesarean scars on labor duration in TOLAC, considering the termination of labor through C-section and selection bias. This study aimed to investigate the impact of cesarean scars on labor duration in TOLAC participants, accounting for potential confounding factors and biases.
Methods: This retrospective cohort study included 2,964 women who attempted vaginal birth at a single center in Japan from 2012 to 2021. The study categorized participants into TOLAC (n = 187) and non-TOLAC (n = 2,777) groups. Propensity scores were calculated based on 14 factors that could influence labor duration, and inverse probability of treatment weighting (IPTW) was applied. Cox proportional hazards regression analysis estimated hazard ratios (HRs) for labor duration, with and without IPTW adjustment. Sensitivity analyses used propensity score matching, bootstrapping, and interval censoring to address potential biases, including recall bias in the reported onset of labor.
Results: The unadjusted HR for labor duration in the TOLAC group compared to the non-TOLAC group was 0.83 (95% CI: 0.70-0.98, P = 0.027), indicating a longer labor duration in the TOLAC group. After adjusting for confounding factors using IPTW, the HR was 0.98 (95% CI: 0.74-1.30, P = 0.91), suggesting no significant difference in labor duration between the groups. Sensitivity analyses using propensity score matching, bootstrapping, and interval censoring yielded consistent results. These findings suggested that the apparent association between TOLAC and longer labor duration was because of confounding factors rather than TOLAC itself.
Conclusions: After adjusting for confounding factors and addressing potential biases, cesarean scars had a limited impact on labor duration in TOLAC participants. Maternal and fetal characteristics may have a more substantial influence on labor duration.
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: Cesarean section; IPTW; Labor duration; Propensity scores; Trial of labor after cesarean section; Vaginal birth
تواريخ الأحداث: Date Created: 20240815 Date Completed: 20240815 Latest Revision: 20240818
رمز التحديث: 20240818
مُعرف محوري في PubMed: PMC11325700
DOI: 10.1186/s12884-024-06744-0
PMID: 39148014
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2393
DOI:10.1186/s12884-024-06744-0