Does the interval since vaginal delivery influence the chance of vaginal birth after cesarean?

Emily Stinnett Miller*, William A Grobman

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Objective: To examine the association between interval since vaginal delivery and vaginal birth after cesarean (VBAC).Methods: Women with one prior low transverse cesarean and a prior vaginal delivery undergoing a trial of labor after cesarean at term were included in this cohort study. Multivariable analyses were performed to determine whether length of time since prior vaginal delivery was independently associated with VBAC and, if so, whether its inclusion enhanced the predictive capacity of previously published models.Results: Of the 5628 women included, 4901 (87%) achieved a VBAC. Each additional year since vaginal delivery decreased the odds of VBAC by 11% (95% CI: 10-13%). When added to an existing predictive model that included only factors available at early prenatal care, interval since vaginal delivery marginally improved the models predictive ability (area under the curve [AUC] 0.73 versus 0.71, p < 0.01). When added to a model that included factors available proximate to the time of delivery, the addition of interval since vaginal delivery did not change the AUC (0.76 versus 0.75, p = 0.08).Conclusions: A longer interval since vaginal delivery is associated with a decreased odd of VBAC. However, the addition of this interval to VBAC prediction models does not substantively improve their predictive ability.

Original languageEnglish (US)
Pages (from-to)294-297
Number of pages4
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume29
Issue number2
DOIs
StatePublished - Jan 17 2016

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Keywords

  • Prediction
  • trial of labor after cesarean
  • vaginal birth after cesarean

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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