Caesarean section and its impact on fertility and time to a subsequent pregnancy in Germany : a database analysis in gynecological practices

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http://hdl.handle.net/10138/228316

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Jacob , L , Weber , K , Sechet , I , Macharey , G , Kostev , K & Ziller , V 2016 , ' Caesarean section and its impact on fertility and time to a subsequent pregnancy in Germany : a database analysis in gynecological practices ' , Archives of Gynecology and Obstetrics , vol. 294 , no. 5 , pp. 1005-1010 . https://doi.org/10.1007/s00404-016-4160-4

Title: Caesarean section and its impact on fertility and time to a subsequent pregnancy in Germany : a database analysis in gynecological practices
Author: Jacob, Louis; Weber, Katherina; Sechet, Ingeborg; Macharey, Georg; Kostev, Karel; Ziller, Volker
Contributor: University of Helsinki, Department of Obstetrics and Gynecology
Date: 2016-11
Language: eng
Number of pages: 6
Belongs to series: Archives of Gynecology and Obstetrics
ISSN: 0932-0067
URI: http://hdl.handle.net/10138/228316
Abstract: To analyze the impact of caesarean section (CS) on fertility and time to pregnancy in German gynecological practices. Women initially diagnosed for the first time with a vaginal delivery (VD) or CS between 2000 and 2013 were identified by 227 gynecologists in the IMS Disease Analyzer database. They were included if they were aged between 16 and 40 years, and were not previously diagnosed with female sterility. The two main outcomes were the first-time diagnosis of female sterility and the time between the first delivery and the next pregnancy within 10 years. A multivariate Cox regression model was used to predict these outcomes on the basis of patient characteristics. 6483 patients were included in the CS group and 6483 in the VD group. Mean age was 30.6 years and the proportion of individuals with private health insurance amounted to 9.0 %. Within 10 years of the index date, 19.5 % of women who delivered by CS and 18.3 % of women who delivered vaginally were diagnosed with sterility (p value = 0.0148). CS and polycystic ovary syndrome significantly increased the risk of sterility. Within 10 years of the index date, 57.9 % of women who underwent a CS and 64.0 % of women who delivered vaginally were pregnant for the second time (p value <0.001). CS, polycystic ovary syndrome, and the deterioration of menstrual cycle significantly decreased the chance of becoming pregnant a second time. CS is associated with an increased risk of sterility and a decreased number of subsequent pregnancies in Germany.
Subject: Caesarean section
Complications
Fertility
Subsequent pregnancies
BIRTH
INFERTILITY
DELIVERY
COHORT
COMPLICATIONS
METAANALYSIS
PERIOD
WOMEN
RISK
3123 Gynaecology and paediatrics
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