Having a caesarean birth may raise the future risk of stillbirth and ectopic pregnancy for a woman, researchers warn today.
The research team, from University College Cork, Ireland and Aarhus University, Denmark, gathered details on 832,996 women from Danish national registers. The team calculated the women’s rate of pregnancy complications following a prior caesarean versus vaginal delivery.
Analysis showed that following a caesarean, women had a 14% increased rate of stillbirth in their next pregnancy compared to women who had a vaginal delivery. However, this translates as an actual risk of only one extra stillbirth after 3,000 caesareans.
Caesareans were also linked to a 9% rise in ectopic pregnancy risk, an actual risk of only one extra ectopic pregnancy after 1,000 caesareans. The study is published today in PLoS Medicine.
Authors Professor Louise Kenny and colleagues point out that, given the global increase in caesarean rates, the results are important.
"Underlying medical conditions, however, and confounding by indication for the primary caesarean delivery account for at least part of this increased rate of subsequent stillbirth and ectopic pregnancy," they write.
"The findings of the current study are particularly important for expectant mothers as well as healthcare professionals as caesarean section rates are increasing significantly worldwide," Professor Kenny said. "These findings highlight the need for women to consider all their options thoroughly before requesting a caesarean section on nonmedical grounds."
But she added that the overall risk remains small. "Whilst we showed that a previous caesarean section is associated with a subsequent stillbirth and ectopic pregnancy, the overall risk of either is very low."
O’Neill, S. M. et al. Cesarean Section and Rate of Subsequent Stillbirth, Miscarriage, and Ectopic Pregnancy: A Danish Register-Based Cohort Study. PLoS Medicine 2 July 2014 doi:10.1371/journal.pmed.1001670 [abstract]
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