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Mode of birth after caesarean section: individual prediction scores using Scottish population data

Denham, Sara Helen; Humphrey, Tracy; deLabrusse, Claire; Dougall, Nadine

Authors

Sara Helen Denham

Tracy Humphrey

Claire deLabrusse



Abstract

Background
Rising caesarean section (CS) rates are a global health concern. Contemporary data indicates that almost 50% of CS are electively performed, with a high proportion of these being a repeat procedure. Vaginal birth after caesarean (VBAC) is recognised as a safe way to give birth in developed countries. UK national maternity policy and worldwide professional guidance supports shared decision-making about mode of birth with women following CS. Evidence suggests that women want individualised information, particularly about their likeilihood of successful VBAC, to enable them to participate in the decision making process. This study aimed to identify characteristics that could inform a predictive model which would allow women to receive personalised and clinically specific information about their likelihood of achieving a successful VBAC in subsequent pregnancies.
Methods
An observational study using anonymised clinical data extracted from a detailed, comprehensive socio-demographic and clinical dataset. All women who attempted a singleton term VBAC between 2000 and 2012 were included. Data were analysed using both logistic regression and Bayesian statistical techniques to identify clinical and demographic variables predictive of successful VBAC.
Results
Variables significantly associated with VBAC were: ethnicity (p = 0.011), maternal obstetric complications (p 

Journal Article Type Article
Acceptance Date Feb 19, 2019
Online Publication Date Feb 28, 2019
Publication Date 2019-12
Deposit Date Mar 7, 2019
Publicly Available Date Mar 7, 2019
Journal BMC Pregnancy and Childbirth
Print ISSN 1471-2393
Publisher BMC
Peer Reviewed Peer Reviewed
Volume 19
Article Number 84
DOI https://doi.org/10.1186/s12884-019-2226-6
Keywords Caesarean section (CS), national maternity policy, VBAC, Vaginal birth after caesarean ,
Public URL http://researchrepository.napier.ac.uk/Output/1643513
Contract Date Mar 7, 2019

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Copyright Statement
© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated







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