Skip to main content
SpringerLink
Log in

Previous cesarean section, gestational age at first delivery and subsequent risk of pre-eclampsia in obese mothers

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

We examine the association between prior C-section and subsequent pre-eclampsia; and describe the effect of gestational age at prior C-section, and obesity status on this association.

Methods

The study population included women with two subsequent singleton births in Missouri between 1998 and 2005. The risk for pre-eclampsia/eclampsia was assessed among women with and without prior cesarean delivery. The two groups were followed to their second pregnancy and the occurrence of pre-eclampsia was documented. Additionally, the history of pre-eclampsia, prior cesarean at preterm, and obesity status were examined for their differential effects on the risk of pre-eclamsia.

Results

Women with prior C-section were 28% more likely to have pre-eclampsia in their subsequent pregnancy [OR = 1.28; 95% CI = 1.20–1.37]. However, this result was not significant when women with pre-eclampsia in their first pregnancy were excluded. After this exclusion, a more than threefold increased risk for subsequent pre-eclampsia was observed in women with prior early C-section [OR = 3.15; 95% CI= 2.43–4.08], while the level of risk did not change in the prior late C-section group [OR = 0.90; 95% CI= 0.82–1.00]. Subgroup analysis suggested that obesity status modified the risk of prior early C-section but did not affect the risk for prior late C-section.

Conclusion

Preterm C-section in the first pregnancy may be associated with subsequent pre-eclampsia regardless of prior pre-eclampsia status.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Allen VM, O’Connell CM, Liston RM, Baskett TF (2003) Maternal morbidity associated with cesarean delivery without labor compared with spontaneous onset of labor at term. Obstet Gynecol 102(3):477–482

    Article  PubMed  CAS  Google Scholar 

  2. Belizán JM, Althabe F, Cafferata ML (2007) Health consequences of the increasing caesarean section rates. Epidemiology 18(4):485–486

    Article  PubMed  Google Scholar 

  3. Declercq E, Barger M, Cabral HJ et al (2007) Maternal outcomes associated with planned primary cesarean births compared with planned vaginal births. Obstet Gynecol 109(3):669–677

    Article  PubMed  Google Scholar 

  4. Miesnik SR, Reale BJ (2007) A review of issues surrounding medically elective cesarean delivery. J Obstet Gynecol Neonatal Nurs 36(6):605–615

    Article  PubMed  Google Scholar 

  5. Gilliam M (2006) Cesarean delivery on request: reproductive consequences. Semin Perinatol 30(5):257–260

    Article  PubMed  Google Scholar 

  6. Smith GC, Pell JP, Dobbie R (2003) Caesarean section and risk of unexplained stillbirth in subsequent pregnancy. Lancet 362(9398):1779–1784

    Article  PubMed  Google Scholar 

  7. Spong CY, Landon MB, Gilbert S, National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network et al (2007) Risk of uterine rupture and adverse perinatal outcome at term after cesarean delivery. Obstet Gynecol 110(4):801–807

    Article  PubMed  Google Scholar 

  8. Daltveit AK, Tollånes MC, Pihlstrøm H, Irgens LM (2008) Cesarean delivery and subsequent pregnancies. Obstet Gynecol 111(6):1327–1334

    Article  PubMed  Google Scholar 

  9. Salihu HM, Weldeselasse HE, Rao K, Marty PJ, Whiteman VE (2011) The impact of obesity on maternal morbidity and feto-infant outcomes among macrosomic infants. J Matern Fetal Neonatal Med [Epub ahead of print]

  10. Mbah AK, Kornosky JL, Kristensen S et al (2010) Super-obesity and risk for early and late pre-eclampsia. BJOG 117(8):997–1004 [Epub 2010 May 19]

    Article  PubMed  CAS  Google Scholar 

  11. Salihu HM, Lynch O, Alio AP, Kornosky JL, Clayton HB, Mbah AK (2009) Extreme obesity and risk of placental abruption. Hum Reprod 24(2):438–444 (Epub 2008 Dec)

    Article  PubMed  CAS  Google Scholar 

  12. Begum KS, Sachchithanantham K, De Somsubhra S (2011) Maternal obesity and pregnancy outcome. Clin Exp Obstet Gynecol 38(1):14–20 (Review)

    PubMed  Google Scholar 

  13. Gunatilake RP, Perlow JH (2011) Obesity and pregnancy: clinical management of the obese gravida. Am J Obstet Gynecol 204(2):106–119 (Review)

    Article  PubMed  Google Scholar 

  14. Murakami M, Ohmichi M, Takahashi T, Shibata A, Fukao A, Morisaki N, Kurachi H (2005) Prepregnancy body mass index as an important predictor of perinatal outcomes in Japanese. Arch Gynecol Obstet 271(4):311–315 [Epub 2004 Jun 5]

    Article  PubMed  Google Scholar 

  15. Herman AA, McCarthy BJ, Bakewell JM et al (1997) Data linkage methods used in maternally-linked birth and infant death surveillance datasets from the United States (Georgia, Missouri, Utah and Washington State), Israel, Norway, Scotland and Western Australia. Paediatr Perinat Epidemiol 11(suppl):5–22

    Article  PubMed  Google Scholar 

  16. Martin J, Curtin S, Saulnier M, Mousavi J (2003) Development of the matched multiple birth file. In: 1995–1998 matched multiple birth dataset. NCHS CD-ROM series 21, no. 13a. National Center for Health Statistics, Hyattsville

  17. Smith GC, Pell JP, Cameron AD, Dobbie R (2002) Risk of perinatal death associated with labor after previous cesarean delivery in uncomplicated term pregnancies. JAMA 287(20):2684–2690

    Article  PubMed  Google Scholar 

  18. Hernández-Díaz S, Toh S, Cnattingius S (2009) Risk of pre-eclampsia in first and subsequent pregnancies: prospective cohort study. BMJ 338:b2255 doi:10.1136/bmj.b2255

    Article  PubMed  Google Scholar 

  19. Taffel S, Johnson D, Heuser R (1982) A method of imputing length of gestation on birth certificates. Vital Health Stat 93:1–11

    Google Scholar 

  20. Piper JM, Mitchel EF Jr, Snowden M, Hall C, Adams M, Taylor P (1993) Validation of 1989 Tennessee birth certificates using maternal and newborn hospital records. Am J Epidemiol 137(7):758–768

    PubMed  CAS  Google Scholar 

  21. Alexander GR, Kotelchuck M (1996) Quantifying the adequacy of prenatal care: a comparison of indices. Public Health Rep 3:408–418

    Google Scholar 

  22. Alexander GR, Cornely DA (1987) Prenatal care utilization: its measurement and relationship to pregnancy outcome. Am J Prevent Med 3:243–253

    CAS  Google Scholar 

  23. Breslow NE, Day NE (1980) Statistical methods in cancer research, vol. I—The analysis of case-control studies. IARC, Lyon Scientific Publ. No 32

    Google Scholar 

  24. Lykke JA, Paidas MJ, Langhoff-Roos J (2009) Recurring complications in second pregnancy. Obstet Gynecol 113(6):1217–1224

    PubMed  Google Scholar 

  25. Barton JR, Sibai BM (2008) Prediction and prevention of recurrent preeclampsia. Obstet Gynecol 112(2 Pt 1):359–372

    Article  PubMed  Google Scholar 

  26. Mostello D, Kallogjeri D, Tungsiripat R, Leet T (2008) Recurrence of preeclampsia: effects of gestational age at delivery of the first pregnancy, body mass index, paternity, and interval between births. Am J Obstet Gynecol 199(1):55.e1–55.e7 [Epub 2008 Feb 15]

    Article  Google Scholar 

  27. Mendilcioglu I, Trak B, Uner M, Umit S, Kucukosmanoglu M (2004) Recurrent preeclampsia and perinatal outcome: a study of women with recurrent preeclampsia compared with women with preeclampsia who remained normotensive during their prior pregnancies. Acta Obstet Gynecol Scand 83(11):1044–1048

    PubMed  Google Scholar 

  28. Tollånes MC (2009) Increased rate of Caesarean sections–causes and consequences. Tidsskr Nor Laegeforen 129(13):1329–1331

    Article  PubMed  Google Scholar 

  29. Getahun D, Oyelese Y, Salihu HM, Ananth CV (2006) Previous cesarean delivery and risks of placenta previa and placental abruption. Obstet Gynecol 107(4):771–778

    Article  PubMed  Google Scholar 

  30. Lydon-Rochelle M, Holt VL, Easterling TR, Martin DP (2001) First-birth cesarean and placental abruption or previa at second birth (1). Obstet Gynecol 97(5 Pt 1):765–769

    Article  PubMed  CAS  Google Scholar 

  31. Hemminki E, Merilainen J (1996) Long-term effects of cesarean sections: ectopic pregnancies and placental problems. Am J Obstet Gynecol 174:1569–1574

    Article  PubMed  CAS  Google Scholar 

  32. Ananth CV, Peltier MR, Chavez MR, Kirby RS, Getahun D, Vintzileos AM (2007) Recurrence of ischemic placental disease. Obstet Gynecol 110(1):128–133

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by a grant from the James & Esther King Biomedical Research Program (Grant # 09KN-07-23141) to Dr. Alfred Mbah. The funding agencies did not play any role in any aspect of the study.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 33612, USA

    Alfred K. Mbah & Hamisu M. Salihu

  2. Department of Obstetrics and Gynecology, University of South Florida, Tampa, FL, 33612, USA

    Karen Bruder & Hamisu M. Salihu

  3. Department of Nursing, University of South Florida, Tampa, FL, 33612, USA

    Doris W. Fombo

  4. US Health Outcomes (Cardiovascular/Oncology), GlaxoSmithKline, Philadelphia, USA

    Puza P. Sharma

  5. Department of Community and Preventive Medicine, University of Rochester, Rochester, USA

    Amina P. Alio

Authors
  1. Alfred K. Mbah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Puza P. Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Amina P. Alio
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Doris W. Fombo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Karen Bruder
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hamisu M. Salihu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alfred K. Mbah.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mbah, A.K., Sharma, P.P., Alio, A.P. et al. Previous cesarean section, gestational age at first delivery and subsequent risk of pre-eclampsia in obese mothers. Arch Gynecol Obstet 285, 1375–1381 (2012). https://doi.org/10.1007/s00404-011-2161-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-011-2161-x

Keywords

Search

Navigation