原创力文档risk of placenta previa in second birth after first birth cesarean section a population-based study and meta-analysis前置胎盘的风险的第二次出生后第一次剖腹产出生以人群为基础的研究和荟萃分析.pdfVIP
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risk of placenta previa in second birth after first birth cesarean section a population-based study and meta-analysis前置胎盘的风险的第二次出生后第一次剖腹产出生以人群为基础的研究和荟萃分析
Gurol-Urganci et al. BMC Pregnancy and Childbirth 2011, 11:95
/1471-2393/11/95
RESEARCH ARTICLE Open Access
Risk of placenta previa in second birth after first
birth cesarean section: a population-based study
and meta-analysis
1,2* 1,2 3 4 2
Ipek Gurol-Urganci , David A Cromwell , Leroy C Edozien , Gordon CS Smith , Chidimma Onwere ,
Tahir A Mahmood2, Allan Templeton2 and Jan H van der Meulen1
Abstract
Background: Objective: To compare the risk of placenta previa at second birth among women who had a
cesarean section (CS) at first birth with women who delivered vaginally.
Methods: Retrospective cohort study of 399,674 women who gave birth to a singleton first and second baby
between April 2000 and February 2009 in England. Multiple logistic regression was used to adjust the estimates for
maternal age, ethnicity, deprivation, placenta previa at first birth, inter-birth interval and pregnancy complications.
In addition, we conducted a meta-analysis of the reported results in peer-reviewed articles since 1980.
Results: The rate of placenta previa at second birth for women with vaginal first births was 4.4 per 1000 births,
compared to 8.7 per 1000 births for women with CS at first birth. After adjustment, CS at first birth remained
associated with an increased risk of placenta previa (odds ratio = 1.60; 95% CI 1.44 to 1.76). In the meta-analysis of
37 previously published studies from 21 countries, the overall pooled random effects odds ratio was 2.20 (95% CI
1.96-2.46). Our results from the current study is consistent with those of the meta-analysis as the pooled odds ratio
for the six population-based cohort studies that analyzed second births only was 1.51 (95% CI 1.39-1.65).
Conclusions: T
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