Risk of Stillbirth After Caesaren Section During the Past 50 Years in Aberdeen

Background

A recent study linking pregnancy discharge data from the Scottish Morbidity Record 2 (SMR02) 1980-1998, and the Scottish Stillbirth and Infant Death Enquiry reported an increased risk of unexplained antepartum stillbirth in second deliveries following caesarean in the first. The reasons for these associations are unclear, the authors of this study recommend both replication of their work using other datasets and further research to identify possible causal mechanisms.

Aim of study

The primary aim of the study is to examine the association between caesarean section at first delivery and stillbirth at second delivery.

Research questions

1. What are the risks of stillbirth at second delivery after previous caesarean section?
2. How has the risk of stillbirth following caesarean section changed over time?
3. What were the reasons for caesarean section at first delivery and is stillbirth more likely after previous CS for some indications than others??
4. Can the association between CS at first delivery and stillbirth at second delivery be explained by confounding factors
5. What is the effect of caesarean section in first pregnancy on other pregnancy outcomes in second pregnancy including birthweight, birthweight for gestation, gestational age at delivery, preterm delivery, neonatal death, pre-eclampsia and antepartum haemorrhage taking into account their incidence in the first pregnancy as many are likely to recur?

Study Design

A retrospective cohort study will be performed to examine the associations between CS at first delivery and pregnancy outcome at second delivery. The data for the study will be retrieved from the Aberdeen Maternity and Neonatal Databank.

The cohort will consist of women who have details of both first and second deliveries recorded the Aberdeen Maternity and Neonatal Databank 1950-2005. For first and second deliveries, data regarding pregnancy complications, labour and delivery will be extracted. For those women who had a CS at first delivery, indications for, and type of CS will be extracted. The anonymised dataset will be stores and analysed using SPSS.

Funding

This study was funded by the Chief Scientists Office.

Grant holders

Dr Doris Campbell
Professor Marion Hall

Research Assistant

Deborah Charles