Systematic review of the effects of birth spacing after cesarean delivery on maternal and perinatal outcomes

Abstract

Background Little is known about the association between birth spacing and subsequent pregnancy outcomes after cesarean delivery. Objectives To summarize the effects of birth spacing after previous caesarean on maternal and perinatal outcomes. Search strategy Four online databases were searched via a multistage search strategy. Selection criteria Studies assessing the effects of birth spacing on any adverse pregnancy outcome after cesarean were included. Data collection and analysis A narrative synthesis was completed. Main results Fifteen studies were included. Eight reported that interpregnancy interval (IPI) shorter than 6 months or birth interval (BI) shorter than 16–18 months increased the risk of uterine rupture during trial of labor after previous cesarean. Most studies found no association of birth spacing with vaginal delivery success following spontaneous labor, but the association with vaginal delivery after induced labor was less certain. BI shorter than 12 months was associated with increased risk of placenta previa and placental abruption. Few studies examined the effect of birth spacing after previous cesarean on perinatal outcomes. Conclusions IPI longer than 6–8 months or BI longer than 18 months was related to decreased risk of maternal morbidity and failed vaginal delivery after previous cesarean.

Factors Associated with Inadequate Birth Intervals in the BRISA Birth Cohort, Brazil

“…2 A recent systematic review including 15 studies shows that birth intervals longer than 18 months were related to decreased risk of maternal morbidity and failed vaginal delivery after previous cesarean section. 31 The high number of women included in the present study and the recruitment strategy increased the possibility of generalization of the findings for women who reside in capitals in the northeastern region of Brazil with similar characteristics.…”

Association of Interpregnancy Interval With Adverse Birth Outcomes

“…Moreover, results of the subgroup analysis suggested that increased odds of adverse birth outcomes after a short IPI of less than 6 months were more pronounced for mothers younger than 35 years than those aged 35 years or older; a similar result was reported in a previous study. 8 Several studies 28 , 34 investigated how IPI and adverse birth outcomes varied by previous delivery mode, but their scope was limited. The present study indicated that mothers with cesarean delivery at first birth had modest increases in the odds of adverse birth outcomes than mothers with vaginal delivery, but the odds did not vary significantly.…”

Maternal death due to ruptured uterus consequent to abruptio placentae: 2 case reports

“…Such consequences can be reduced by creating awareness among the high-risk pregnancy groups as well as among TBA. We also recommend that patients with a previous LSCS must avoid subsequent pregnancy for at least 6-8 months (Ye et al, 2019).…”