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Previous C-section 'does not raise stillbirth risk'

04/06/2008

Women who have had a caesarean section do not have an increased risk of stillbirth in following pregnancies, new research suggests.

The findings, published in BJOG: An International Journal of Obstetrics and Gynaecology, go against a previous study which linked caesareans with stillbirth in second pregnancies.

Researchers behind the latest study from the University of Calgary say the earlier report failed to account for the effects of maternal obesity, which is associated with both caesarean birth and stillbirth.

Their study analysed 157,929 second births with information obtained on demographic characteristics, pregnancy complications, mode of delivery and outcome of live or stillbirth.

Information was also gained on factors that could impact on the results such as maternal diabetes, maternal weight, hypertension and smoking during pregnancy.

Data was then adjusted to exclude other potential contributing factors such as significant fetal abnormality, maternal trauma such as a motor vehicle accident during pregnancy and infections.

Once these factors were taken into account, there were a total of 265 antenatal stillbirths; 63 (2.1/1000) in the previous caesarean group and 202 (1.6/1000) in the previous vaginal birth group.

Dr Stephen Wood from the University of Calgary said: "Our study strongly suggests that previous caesarean section does not increase the risk of stillbirth in subsequent pregnancies.

"Although previous research has made a link between the two, it is likely that maternal obesity played a part as it was not controlled for."

He added that as "caesarean section is increasingly common and stillbirth is a very important outcome further research in this area is required".

Commenting on the research, Professor Philip Steer, BJOG editor-in-chief, said: "The increase in stillbirth risk previously reported was especially concerning, so it is somewhat reassuring that the study by Dr Wood and his team suggests that this may have been due to the confounding factor of maternal obesity.

"Because of the growing prevalence of caesarean section, further research is needed to ascertain in more detail the pros and cons of c-section delivery."