Impact of previous cesarean delivery on reproductive outcomes of assisted reproductive technology: a Bayesian network meta-analysis
Objective To systematically review the impact of vaginal delivery (VD), cesarean scar (CS), cesarean scar disorder (CSD) and intra-cavitary fluid (ICF) on the reproductive outcomes of women involving assisted reproductive technology (ART) based on Bayesian network meta-analysis.Methods Six databases...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2541420 |
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| author | Kun Ma Shuo Jin Chenhan Zhao Rongyun Wang Liuqing Yang Jing Ma Cong Gao Lihua Sun Qin Zhang Ling Wang |
| author_facet | Kun Ma Shuo Jin Chenhan Zhao Rongyun Wang Liuqing Yang Jing Ma Cong Gao Lihua Sun Qin Zhang Ling Wang |
| author_sort | Kun Ma |
| collection | DOAJ |
| description | Objective To systematically review the impact of vaginal delivery (VD), cesarean scar (CS), cesarean scar disorder (CSD) and intra-cavitary fluid (ICF) on the reproductive outcomes of women involving assisted reproductive technology (ART) based on Bayesian network meta-analysis.Methods Six databases were searched from the inception to October 16, 2024. Primary outcomes were clinical pregnancy rate and live birth rate. Secondary outcomes included positive human chorionic gonadotropin (hCG) test rate, miscarriage rate, ectopic pregnancy rate, and severe adverse pregnancy outcomes. Extracted study data were analyzed by pairwise and network meta-analysis using R software and Stata.Results This study revealed that CS, CSD and ICF significantly reduced clinical pregnancy rate (CS vs VD: RR = 0.88, 95% CI 0.78-0.99, p < 0.05; CSD vs VD: RR = 0.72, 95% CI 0.59-0.86, p < 0.05; ICF vs VD: RR = 0.63, 95% CI 0.46-0.82, p < 0.05), and live birth rate (CS vs VD: RR = 0.86, 95% CI 0.76-0.97, p < 0.05; CSD vs VD: RR = 0.65, 95% CI 0.52-0.79, p < 0.05; ICF vs VD: RR = 0.61, 95% CI 0.43-0.82, p < 0.05) compared to VD. Furthermore, CSD had a lower live birth rate than CS (RR = 0.75, 95% CI 0.59-0.95, p < 0.05); ICF decreased both clinical pregnancy rate (RR = 0.72, 95% CI 0.51-0.95, p < 0.05) and live birth rate (RR = 0.71, 95% CI 0.49-0.97, p < 0.05) compared with CS.Conclusions ICF, CSD, and CS all significantly reduce clinical pregnancy rate and live birth rate in women with ART. CSD and ICF had much lower live birth rate than CS. Notably, ICF was a prominent risk factor for these adverse reproductive outcomes.Trial registration Registered with PROSPERO on October 19, 2024, CRD42024603479. |
| format | Article |
| id | doaj-art-cbb80e28aac546ecb8b27c3b85b95a4f |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-cbb80e28aac546ecb8b27c3b85b95a4f2025-08-20T04:01:48ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2541420Impact of previous cesarean delivery on reproductive outcomes of assisted reproductive technology: a Bayesian network meta-analysisKun Ma0Shuo Jin1Chenhan Zhao2Rongyun Wang3Liuqing Yang4Jing Ma5Cong Gao6Lihua Sun7Qin Zhang8Ling Wang9Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, ChinaWenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, ChinaHangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, ChinaSchool of Nursing, Zhejiang Chinese Medical University, Hangzhou, ChinaHangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, ChinaHangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, ChinaXiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, ChinaXiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, ChinaHangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, ChinaXiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, ChinaObjective To systematically review the impact of vaginal delivery (VD), cesarean scar (CS), cesarean scar disorder (CSD) and intra-cavitary fluid (ICF) on the reproductive outcomes of women involving assisted reproductive technology (ART) based on Bayesian network meta-analysis.Methods Six databases were searched from the inception to October 16, 2024. Primary outcomes were clinical pregnancy rate and live birth rate. Secondary outcomes included positive human chorionic gonadotropin (hCG) test rate, miscarriage rate, ectopic pregnancy rate, and severe adverse pregnancy outcomes. Extracted study data were analyzed by pairwise and network meta-analysis using R software and Stata.Results This study revealed that CS, CSD and ICF significantly reduced clinical pregnancy rate (CS vs VD: RR = 0.88, 95% CI 0.78-0.99, p < 0.05; CSD vs VD: RR = 0.72, 95% CI 0.59-0.86, p < 0.05; ICF vs VD: RR = 0.63, 95% CI 0.46-0.82, p < 0.05), and live birth rate (CS vs VD: RR = 0.86, 95% CI 0.76-0.97, p < 0.05; CSD vs VD: RR = 0.65, 95% CI 0.52-0.79, p < 0.05; ICF vs VD: RR = 0.61, 95% CI 0.43-0.82, p < 0.05) compared to VD. Furthermore, CSD had a lower live birth rate than CS (RR = 0.75, 95% CI 0.59-0.95, p < 0.05); ICF decreased both clinical pregnancy rate (RR = 0.72, 95% CI 0.51-0.95, p < 0.05) and live birth rate (RR = 0.71, 95% CI 0.49-0.97, p < 0.05) compared with CS.Conclusions ICF, CSD, and CS all significantly reduce clinical pregnancy rate and live birth rate in women with ART. CSD and ICF had much lower live birth rate than CS. Notably, ICF was a prominent risk factor for these adverse reproductive outcomes.Trial registration Registered with PROSPERO on October 19, 2024, CRD42024603479.https://www.tandfonline.com/doi/10.1080/07853890.2025.2541420Cesarean scarcesarean scar disordervaginal deliveryintra-cavitary fluidassisted reproductive technologyreproductive outcome |
| spellingShingle | Kun Ma Shuo Jin Chenhan Zhao Rongyun Wang Liuqing Yang Jing Ma Cong Gao Lihua Sun Qin Zhang Ling Wang Impact of previous cesarean delivery on reproductive outcomes of assisted reproductive technology: a Bayesian network meta-analysis Annals of Medicine Cesarean scar cesarean scar disorder vaginal delivery intra-cavitary fluid assisted reproductive technology reproductive outcome |
| title | Impact of previous cesarean delivery on reproductive outcomes of assisted reproductive technology: a Bayesian network meta-analysis |
| title_full | Impact of previous cesarean delivery on reproductive outcomes of assisted reproductive technology: a Bayesian network meta-analysis |
| title_fullStr | Impact of previous cesarean delivery on reproductive outcomes of assisted reproductive technology: a Bayesian network meta-analysis |
| title_full_unstemmed | Impact of previous cesarean delivery on reproductive outcomes of assisted reproductive technology: a Bayesian network meta-analysis |
| title_short | Impact of previous cesarean delivery on reproductive outcomes of assisted reproductive technology: a Bayesian network meta-analysis |
| title_sort | impact of previous cesarean delivery on reproductive outcomes of assisted reproductive technology a bayesian network meta analysis |
| topic | Cesarean scar cesarean scar disorder vaginal delivery intra-cavitary fluid assisted reproductive technology reproductive outcome |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2541420 |
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