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Caesarean birth in women with infertility: population-based cohort study.
Richmond, E; Ray, J G; Pudwell, J; Djerboua, M; Gaudet, L; Walker, M; Smith, G N; Velez, M P.
Afiliación
  • Richmond E; Department of Obstetrics & Gynaecology, Kingston General Hospital, Queen's University, Kingston, ON, Canada.
  • Ray JG; ICES, Toronto, ON, Canada.
  • Pudwell J; Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
  • Djerboua M; Department of Obstetrics & Gynaecology, Kingston General Hospital, Queen's University, Kingston, ON, Canada.
  • Gaudet L; ICES, Toronto, ON, Canada.
  • Walker M; Department of Obstetrics & Gynaecology, Kingston General Hospital, Queen's University, Kingston, ON, Canada.
  • Smith GN; Department of Obstetrics, Gynaecology & Newborn Care, University of Ottawa, Ottawa, ON, Canada.
  • Velez MP; Department of Obstetrics & Gynaecology, Kingston General Hospital, Queen's University, Kingston, ON, Canada.
BJOG ; 129(6): 908-916, 2022 May.
Article en En | MEDLINE | ID: mdl-34797929
OBJECTIVE: Caesarean section (CS) is more common following infertility treatment (IT) but the reasons why remain unclear and confounded. The Robson 10-Group Classification System (TGCS) may further explain variation in CS rates. We assessed the association between mode of conception and CS across Robson groups. DESIGN: Population-based cohort study. SETTING: Ontario, Canada, in a public healthcare system. POPULATION: 921 023 births, 2006-2014. METHODS: Modified Poisson regression produced relative risks (RR) and 95% confidence intervals, comparing the risk of CS among women with (1) subfertility without IT, (2) non-invasive IT (OI, IUI) or (3) invasive IT (IVF)-each relative to (4) spontaneous conception (SC). MAIN OUTCOME MEASURES: CS rate according to one of four modes of conception, overall and stratified by each of the TGCS groups. RESULTS: Relative to SC (26.9%), the risk of CS increased in those with subfertility without IT (RR 1.17, 95% CI 1.16-1.18), non-invasive IT (RR 1.21, 95% CI 1.18-1.24) and invasive IT (RR 1.39, 95% CI 1.36-1.42). Within each Robson group, similar patterns of RRs were seen, but with markedly differing rates. For example, in Group 1 (nulliparous, singleton, cephalic at ≥37 weeks, with spontaneous labour), the respective rates were 15.0, 19.4, 18.7 and 21.9%; in Group 2 (nulliparous, singleton, cephalic at ≥37 weeks, without spontaneous labour), the rates were 35.9, 44.4, 43.2 and 54.1%; and in Group 8 (multiple pregnancy), they were 55.9, 67.5, 65.0 and 69.3%, respectively. CONCLUSIONS: CS is relatively more common in women with subfertility and those receiving IT, an effect that persists across Robson groups. TWEETABLE ABSTRACT: Caesarean delivery is more common in women with infertility independent of demographics and prenatal conditions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cesárea / Infertilidad Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Female / Humans / Male / Pregnancy País/Región como asunto: America do norte Idioma: En Revista: BJOG Asunto de la revista: GINECOLOGIA / OBSTETRICIA Año: 2022 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cesárea / Infertilidad Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Female / Humans / Male / Pregnancy País/Región como asunto: America do norte Idioma: En Revista: BJOG Asunto de la revista: GINECOLOGIA / OBSTETRICIA Año: 2022 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido