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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Main Authors: Kun Ma, Shuo Jin, Chenhan Zhao, Rongyun Wang, Liuqing Yang, Jing Ma, Cong Gao, Lihua Sun, Qin Zhang, Ling Wang
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
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.
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institution Kabale University
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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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