Health outcomes up to 5 years in children born as a second child after a previous caesarean section in a first pregnancy: a Swedish population-based register study between 1999 and 2015
Objective To explore health outcomes up to 5 years of age, according to mode of birth, in a large cohort of Swedish children who were born as a second child to women who had a caesarean section (CS) in their first pregnancy.Design Retrospective population-based register study.Population All children...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-03-01
|
| Series: | BMJ Paediatrics Open |
| Online Access: | https://bmjpaedsopen.bmj.com/content/9/1/e003026.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849393798154551296 |
|---|---|
| author | Anna Dencker Anders Elfvin Valerie Smith Lars Ladfors Huiqi Li Ingela Lundgren Ida Lyckestam Thelin Christina Nilsson |
| author_facet | Anna Dencker Anders Elfvin Valerie Smith Lars Ladfors Huiqi Li Ingela Lundgren Ida Lyckestam Thelin Christina Nilsson |
| author_sort | Anna Dencker |
| collection | DOAJ |
| description | Objective To explore health outcomes up to 5 years of age, according to mode of birth, in a large cohort of Swedish children who were born as a second child to women who had a caesarean section (CS) in their first pregnancy.Design Retrospective population-based register study.Population All children (n=94 498) who were born as a second child (or children in cases of twins or higher-order multiple births) during 1999–2015 in Sweden in women who had a CS first birth. The children were followed up to 5 years of age. For inclusion, both births must have occurred in Sweden.Methods A nationwide cohort study using follow-up data up to 5 years of age. Maternal factors, including age, smoking, diabetes, obesity (body mass index ≥30), mental illness, pre-eclampsia, education, income, country of birth and the neonatal factors of being a singleton and prematurity (up to week 36+6) were adjusted for in regression models.Main outcome measures Developmental problems, asthma, allergy, hospital care and death within 5 years of age.Results A total of 94 498 children were included in the study. Risk for developmental problems, asthma and allergy was increased after repeat CS but not after vaginal birth. The need for hospital care was increased in all other birth modes compared with spontaneous vaginal birth. The risk of death within 5 years increased after instrumental vaginal birth and emergency repeat CS.Conclusions All repeat CS compared with spontaneous vaginal birth was related to increased risks for developmental problems, asthma, allergy and hospital stay, and emergency repeat CS was associated with an increased risk of death within 5 years. The results of the present study support vaginal birth as the optimal mode of birth after previous CS for longer-term child health outcomes. |
| format | Article |
| id | doaj-art-98b4e4c32b214c2caedd98bf5d8d9631 |
| institution | Kabale University |
| issn | 2399-9772 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Paediatrics Open |
| spelling | doaj-art-98b4e4c32b214c2caedd98bf5d8d96312025-08-20T03:40:17ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722025-03-019110.1136/bmjpo-2024-003026Health outcomes up to 5 years in children born as a second child after a previous caesarean section in a first pregnancy: a Swedish population-based register study between 1999 and 2015Anna Dencker0Anders Elfvin1Valerie Smith2Lars Ladfors3Huiqi Li4Ingela Lundgren5Ida Lyckestam Thelin6Christina Nilsson7Institute of Health and Care Sciences, Sahlgrenska Akademy, University of Gothenbourg, Gothenbourg, Sweden10 Department of Pediatrics, Sahlgrenska University Hospital, Goteborg, SwedenDurham Veterans Affairs Hospital, Durham, North Carolina, USADepartment of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Goteborg, SwedenSchool of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, SwedenInstitute of Health and Care Sciences, Sahlgrenska Akademy, University of Gothenbourg, Gothenbourg, SwedenInstitute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, SwedenMunkebäck Antenatal Clinic, Västra Götalandsregionen, Gothenburg, SwedenObjective To explore health outcomes up to 5 years of age, according to mode of birth, in a large cohort of Swedish children who were born as a second child to women who had a caesarean section (CS) in their first pregnancy.Design Retrospective population-based register study.Population All children (n=94 498) who were born as a second child (or children in cases of twins or higher-order multiple births) during 1999–2015 in Sweden in women who had a CS first birth. The children were followed up to 5 years of age. For inclusion, both births must have occurred in Sweden.Methods A nationwide cohort study using follow-up data up to 5 years of age. Maternal factors, including age, smoking, diabetes, obesity (body mass index ≥30), mental illness, pre-eclampsia, education, income, country of birth and the neonatal factors of being a singleton and prematurity (up to week 36+6) were adjusted for in regression models.Main outcome measures Developmental problems, asthma, allergy, hospital care and death within 5 years of age.Results A total of 94 498 children were included in the study. Risk for developmental problems, asthma and allergy was increased after repeat CS but not after vaginal birth. The need for hospital care was increased in all other birth modes compared with spontaneous vaginal birth. The risk of death within 5 years increased after instrumental vaginal birth and emergency repeat CS.Conclusions All repeat CS compared with spontaneous vaginal birth was related to increased risks for developmental problems, asthma, allergy and hospital stay, and emergency repeat CS was associated with an increased risk of death within 5 years. The results of the present study support vaginal birth as the optimal mode of birth after previous CS for longer-term child health outcomes.https://bmjpaedsopen.bmj.com/content/9/1/e003026.full |
| spellingShingle | Anna Dencker Anders Elfvin Valerie Smith Lars Ladfors Huiqi Li Ingela Lundgren Ida Lyckestam Thelin Christina Nilsson Health outcomes up to 5 years in children born as a second child after a previous caesarean section in a first pregnancy: a Swedish population-based register study between 1999 and 2015 BMJ Paediatrics Open |
| title | Health outcomes up to 5 years in children born as a second child after a previous caesarean section in a first pregnancy: a Swedish population-based register study between 1999 and 2015 |
| title_full | Health outcomes up to 5 years in children born as a second child after a previous caesarean section in a first pregnancy: a Swedish population-based register study between 1999 and 2015 |
| title_fullStr | Health outcomes up to 5 years in children born as a second child after a previous caesarean section in a first pregnancy: a Swedish population-based register study between 1999 and 2015 |
| title_full_unstemmed | Health outcomes up to 5 years in children born as a second child after a previous caesarean section in a first pregnancy: a Swedish population-based register study between 1999 and 2015 |
| title_short | Health outcomes up to 5 years in children born as a second child after a previous caesarean section in a first pregnancy: a Swedish population-based register study between 1999 and 2015 |
| title_sort | health outcomes up to 5 years in children born as a second child after a previous caesarean section in a first pregnancy a swedish population based register study between 1999 and 2015 |
| url | https://bmjpaedsopen.bmj.com/content/9/1/e003026.full |
| work_keys_str_mv | AT annadencker healthoutcomesupto5yearsinchildrenbornasasecondchildafterapreviouscaesareansectioninafirstpregnancyaswedishpopulationbasedregisterstudybetween1999and2015 AT anderselfvin healthoutcomesupto5yearsinchildrenbornasasecondchildafterapreviouscaesareansectioninafirstpregnancyaswedishpopulationbasedregisterstudybetween1999and2015 AT valeriesmith healthoutcomesupto5yearsinchildrenbornasasecondchildafterapreviouscaesareansectioninafirstpregnancyaswedishpopulationbasedregisterstudybetween1999and2015 AT larsladfors healthoutcomesupto5yearsinchildrenbornasasecondchildafterapreviouscaesareansectioninafirstpregnancyaswedishpopulationbasedregisterstudybetween1999and2015 AT huiqili healthoutcomesupto5yearsinchildrenbornasasecondchildafterapreviouscaesareansectioninafirstpregnancyaswedishpopulationbasedregisterstudybetween1999and2015 AT ingelalundgren healthoutcomesupto5yearsinchildrenbornasasecondchildafterapreviouscaesareansectioninafirstpregnancyaswedishpopulationbasedregisterstudybetween1999and2015 AT idalyckestamthelin healthoutcomesupto5yearsinchildrenbornasasecondchildafterapreviouscaesareansectioninafirstpregnancyaswedishpopulationbasedregisterstudybetween1999and2015 AT christinanilsson healthoutcomesupto5yearsinchildrenbornasasecondchildafterapreviouscaesareansectioninafirstpregnancyaswedishpopulationbasedregisterstudybetween1999and2015 |