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Term Cesarean Delivery & Subsequent Preterm Delivery

Am J Obstet Gynecol; ePub 2019 Feb 22; Vahanian, et al

Cesarean delivery at term is not associated with an increase in preterm delivery, spontaneous or indicated, in the subsequent pregnancy, a new study found. The retrospective cohort study consisted of women with the first 2 consecutive singleton deliveries (2007‒2014) identified through a linked pregnancy database at a single institution. Women with a first pregnancy that resulted in cesarean delivery at term were compared to women whose first pregnancy resulted in a vaginal delivery at term. The primary outcome was the overall preterm delivery <37 weeks in the second pregnancy. Researchers found:

  • Of a total of 6,456 linked pregnancies, 2,284 deliveries were matched; 1,142 were preceded by cesarean delivery and 1,142 by vaginal delivery.
  • The risks of preterm delivery in the second pregnancy among women with a previous cesarean and vaginal delivery were 6.0% and 5.2%, respectively.
  • No associations were seen between cesarean delivery in the first pregnancy and spontaneous preterm delivery.
  • Similarly, no significant differences were found in late preterm delivery, early preterm delivery, or neonates with birthweight <5th percentile for gestational age.


Vahanian SA, Hoffman MK, Ananth CV, et al. Term cesarean delivery in the first pregnancy is not associated with an increased risk for preterm delivery in the subsequent pregnancy. [Published online ahead of print February 22, 2019]. Am J Obstet Gynecol. doi:10.1016/j.ajog.2019.02.036.