Table 6.
Association between number of previous caesarean sections and pregnancy outcomes among multiparous pregnant women.
| Pregnancy outcomes | Crude analysis | Adjusted analysis* | ||||||
|---|---|---|---|---|---|---|---|---|
| 1 CS | 2 CS | 1 CS | 2 CS | |||||
| OR (95% CI) | p-value | OR (95% CI) | p-value | OR (95% CI) | p-value | OR (95% CI) | p-value | |
| Maternal outcomes | ||||||||
| Maternal death | 1.01 (0.63, 1.62) | 0.975 | 2.28 (1.29, 4.05) | 0.005 | 0.92 (0.54, 1.58) | 0.764 | 1.59 (0.81, 3.09) | 0.174 |
| Maternal near miss | 1.58 (1.32, 1.89) | <0.001 | 3.06 (2.43, 3.84) | <0.001 | 1.62 (1.32, 1.99) | <0.001 | 2.75 (2.11, 3.57) | <0.001 |
| Severe maternal outcome | 1.50 (1.27, 1.77) | <0.001 | 2.94 (2.38, 3.64) | <0.001 | 1.52 (1.25, 1.85) | <0.001 | 2.63 (2.05, 3.37) | <0.001 |
| Placenta Praevia | 1.47 (1.23, 1.76) | <0.001 | 3.13 (2.50, 3.91) | <0.001 | 1.50 (1.23, 1.81) | <0.001 | 2.51 (1.97, 3.20) | <0.001 |
| Accreta/increta/Percreta placenta | 2.09 (1.57, 2.78) | <0.001 | 6.99 (4.93, 9.92) | <0.001 | 1.90 (1.39, 2.59) | <0.001 | 5.85 (3.99, 8.58) | <0.001 |
| Abruption placenta | 1.07 (0.84, 1.35) | 0.592 | 0.83 (0.54, 1.28) | 0.397 | 1.15 (0.89, 1.48) | 0.283 | 0.61 (0.38, 0.98) | 0.042 |
| Ruptured Uterus | 6.79 (4.87, 9.48) | <0.001 | 7.25 (4.56, 11.51) | <0.001 | 8.23 (5.71, 11.84) | <0.001 | 6.50 (3.92, 10.76) | <0.001 |
| Neonatal outcomes | ||||||||
| Fresh stillbirth | 1.01 (0.88, 1.16) | 0.908 | 0.87 (0.67, 1.12) | 0.274 | 1.05 (0.90, 1.21) | 0.555 | 0.70 (0.54, 0.92) | 0.010 |
| Macerated stillbirth | 0.74 (0.61, 0.89) | 0.001 | 0.92 (0.69, 1.23) | 0.581 | 0.81 (0.67, 0.99) | 0.044 | 0.75 (0.55, 1.03) | 0.072 |
| Early neonatal death | 1.03 (0.88, 1.19) | 0.743 | 1.44 (1.16, 1.79) | <0.001 | 1.02 (0.87, 1.20) | 0.805 | 1.25 (0.98, 1.57) | 0.067 |
| Perinatal death | 0.90 (0.81, 1.01) | 0.066 | 0.90 (0.75, 1.09) | 0.285 | 0.96 (0.85, 1.09) | 0.562 | 0.74 (0.60, 0.91) | 0.004 |
| Neonatal near miss | 1.17 (1.10, 1.24) | <0.001 | 1.47 (1.34, 1.61) | <0.001 | 1.15 (1.07, 1.23) | <0.001 | 1.33 (1.20, 1.47) | <0.001 |
| NICU admission | 1.25 (1.18, 1.32) | <0.001 | 1.64 (1.51, 1.80) | <0.001 | 1.24 (1.16, 1.33) | <0.001 | 1.53 (1.38, 1.69) | <0.001 |
| Apgar score at 5 min < 7 | 1.09 (0.98, 1.21) | 0.096 | 1.26 (1.07, 1.48) | 0.006 | 1.04 (0.93, 1.16) | 0.523 | 1.11 (0.93, 1.32) | 0.239 |
| Preterm birth (<37 weeks) | 0.96 (0.91, 1.02) | 0.175 | 1.49 (1.38, 1.62) | <0.001 | 0.97 (0.90, 1.03) | 0.314 | 1.42 (1.29, 1.58) | <0.001 |
| Low birthweight (<2500 g)** | 0.98 (0.93, 1.03) | 0.350 | 1.27 (1.17, 1.37) | <0.001 | 0.95 (0.90, 0.99) | 0.049 | 1.21 (1.11, 1.31) | <0.001 |
Multiparous women without previous caesarean section is the reference. Note: *Adjusted for individual level: maternal age, marital status, years of maternal school attendance, indirect causes (anaemia, malaria/dengue, HIV, heart disease, lung disease, renal disease, hepatic disease, and chronic hypertension), pre-eclampsia/eclampsia, fetal presentation, birthweight; facility level: blood bank, adult intensive care unit, neonatal intensive care unit. **Excluded birthweight from the model.
CI = confidence interval, NICU = neonatal intensive care unit, aOR = adjusted OR.