Table 1.
Mode of delivery among women with a history of prior cesarean birth between October 1, 2018 and October 1, 2019 in the Southwest Trifinio, Guatemala.
| Total Population (n = 35) |
Vaginal Birth After Cesarean (n = 10, 28.6 %) |
Elective Repeat Cesarean Birth, Pre-labor (n = 22, 62.9%) |
Repeat Cesarean Birth, Intrapartum (n = 3, 8.6%) |
P-value | |
|---|---|---|---|---|---|
| Sociodemographic Characteristics | |||||
| 0 % missing | 0 % missing | ||||
| Age in years (median, IQR) | 22.9 [21.1,28.4] | 25.5 [22.7,28.2] | 22.6 [20.9,29.6] | 22.6 [21.3,23.0] | 0.69a |
| 0 % missing | 0 % missing | ||||
| Education | 1.0 | ||||
| None | 4 (11.4 %) | 1 (10.0 %) | 3 (13.6 %) | 0 (0.0 %) | |
| Any | 31 (88.6 %) | 9 (90.0 %) | 19 (86.4 %) | 3 (100.0 %) | |
| 0 % missing | 0 % missing | ||||
| Not Employed | 35 (100 %) | 10 (100 %) | 22 (100 %) | 3 (100 %) | - |
| 0 % missing | 0 % missing | ||||
| Not Single (Marital Status) | 33 (94.3 %) | 9 (90.0 %) | 21 (95.5 %) | 3 (100.0 %) | 0.61 |
| n = 33, 5.7 % missing | n = 33, 5.7 % missing | ||||
| Weekly Income (Quetzales) | 0.33 | ||||
| 0 - 500 | 28 (84.9 %) | 7 (70.0 %) | 18 (90.0 %) | 3 (100.0 %) | |
| 500 - 1000 | 5 (15.2 %) | 3 (30.0 %) | 2 (10.0 %) | 0 (0.0 %) | |
| 0 % missing | 0 % missing | ||||
| Community | + | 0.24 | |||
| 1 | 2 (5.7 %) | 0 (10.0 %) | 2 (9.1 %) | 0 (0.0 %) | |
| 2 | 2 (5.7 %) | 2 (20.0 %) | 0 (0.0 %) | 0 (0.0 %) | |
| 3 | 6 (17.1 %) | 1 (10.0 %) | 5 (22.7 %) | 0 (0.0 %) | |
| 4 | 3 (8.6 %) | 0 (0.0 %) | 3 (13.6 %) | 0 (0.0 %) | |
| 5 | 5 (14.3 %) | 2 (20.0 %) | 2 (9.1 %) | 1 (33.3 %) | |
| 6 | 0 (0.0 %) | 0 (0.0 %) | 0 (0.0 %) | 0 (0.0 %) | |
| 7 | 1 (2.9 %) | 1 (10.0 %) | 0 (0.0 %) | 0 (0.0 %) | |
| 8 | 8 (22.9 %) | 4 (40.0 %) | 3 (13.6 %) | 1 (33.3 %) | |
| 9 | 0 (0.0 %) | 0 (0.0 %) | 0 (0.0 %) | 0 (0.0 %) | |
| 10 | 2 (5.7 %) | 0 (0.0 %) | 2 (9.1 %) | 0 (0.0 %) | |
| 11 | 1 (2.9 %) | 0 (0.0 %) | 1 (4.6 %) | 0 (0.0 %) | |
| 12 | 5 (14.3 %) | 0 (0.0 %) | 4 (18.2 %) | 1 (33.3 %) | |
| Obstetric and Antepartum Characteristics | |||||
| n = 32, 8.6 % missing | n = 32, 8.6 % missing | ||||
| Interpregnancy Interval in months (median, IQR) | 32.7 [18.7,45.8] | 45.5 [30.9,49.5] | 26.7 [13.8,36.0] | 36.5 [34.2,63.2] | 0.06a |
| 0 % missing | 0 % missing | ||||
| Parity at Enrollment | 0.004 | ||||
| 1 | 16 (45.7 %) | 1 (10.0 %) | 12 (54.6 %) | 3 (100.0 %) | |
| 2+ | 19 (54.3 %) | 9 (90.0 %) | 10 (45.5 %) | 0 (0.0 %) | |
| 0 % missing | 0 % missing | ||||
| Number of Prior Cesarean Births | 0.53 | ||||
| 1 | 25 (71.4 %) | 6 (60.0 %) | 16 (72.7 %) | 3 (100 %) | |
| 2 | 10 (28.6 %) | 4 (40.0 %) | 6 (27.3 %) | 0 (0.0 %) | |
| 0 % missing | 0 % missing | ||||
| Trimester mother entered care | 0.29 | ||||
| First | 7 (14.3 %) | 0 (0.0 %) | 6 (27.3 %) | 1 (33.3 %) | |
| Second | 20 (40.0 %) | 7 (70.0 %) | 12 (54.6 %) | 1 (33.3 %) | |
| Third | 8 (45.7 %) | 3 (30.0 %) | 4 (18.2 %) | 1 (33.3 %) | |
| 0 % missing | 0 % missing | ||||
| Number of Madres Sanas PNVs* | |||||
| <4 | 7 (74.3 %) | 4 (40.0 %) | 3 (13.6 %) | 0 (0.0 %) | 0.24 |
| 4+ | 28 (25.7 %) | 6 (60.0 %) | 19 (86.4 %) | 3 (100.0 %) | |
| Delivery Characteristics | |||||
| n = 34, 2.9 % missing | n = 34, 2.9 % missing | ||||
| Location of Delivery | <0.001** | ||||
| Home or Other | 6 (17.7 %) | 6 (60.0 %) | 0 (0.0 %) | 0 (0.0 %) | |
| Facility | 28 (82.4 %) | 4 (40.0 %) | 21 (100 %) | 3 (100 %) | |
| 0 % missing | 0 % missing | ||||
| Birth Attendant | 0.002** | ||||
| Comadrona (TBA) or Family | 5 (14.3 %) | 5 (50.0 %) | 0 (0.0 %) | 0 (0.0 %) | |
| Nurse or Physician | 30 (85.7 %) | 5 (50.0 %) | 22 (100 %) | 3 (100 %) | |
| 0 % missing | 0 % missing | ||||
| Infant Sex | 0.26 | ||||
| Male | 17 (48.6 %) | 6 (60.0 %) | 11 (50.0 %) | 0 (0.0 %) | |
| Female | 18 (51.4 %) | 4 (40.0 %) | 11 (50.0 %) | 3 (100 %) | |
| 0 % missing | 0 % missing | ||||
| Gestational Age | 0.49 | ||||
| Preterm (< 37 + 0) | 3 (8.6 %) | 2 (20.0 %) | 1 (4.6 %) | 0 (0.0 %) | |
| Term (37 + 0–40 + 6) | 13 (37.1 %) | 3 (30.0 %) | 8 (36.4 %) | 2 (66.7 %) | |
| Late Term (41 + 0–41 + 6) | 9 (25.7 %) | 1(10.0 %) | 7 (31.8 %) | 1 (33.3 %) | |
| Postterm (≥ 42 + 0) | 10 (29.6 %) | 4 (40.0 %) | 6 (27.3 %) | 0 (0.0 %) | |
| 0 % missing | 0 % missing | ||||
| Birthweight at Delivery in grams (mean, SD) | 2940 ± 497 | 3008 ± 633 | 2921 ± 480 | 2872 ± 130 | 0.64b |
| 0 % missing | 0 % missing | ||||
| Antepartum or Intrapartum Obstetric/Maternal Complication | 19 (54.3 %) | 3 (30.0 %) | 14 (63.6 %) | 2 (66.7 %) | 0.39c |
| 0 % missing | 0 % missing | ||||
| Skin-to-Skin | 13 (37.1 %) | 6 (60.0 %) | 5 (22.7 %) | 2 (66.7 %) | 0.07 |
| 0 % missing | 0 % missing | ||||
| Breastfed Within 1 Hour of Birth | 11 (31.4 %) | 4 (40.0 %) | 7 (31.8 %) | 0 (0.0 %) | 0.54 |
*
PNVs: prenatal visits, TBA: traditional birth attendant.
Note: p-value is the result of Fisher’s exact testing unless otherwise noted.
**
Attendant and hospital were highly correlated with pearson’s coefficient of 0.88.
NOTE: too much missing data on: neonatal outcomes (22.9 % missing).
a
Kruskal-Wallis test.
b
ANOVA test.
c
Maternal/obstetric complications included obstructed labor, hemorrhage (antepartum, intrapartum, postpartum), uterine rupture, hypertensive disease/pre-eclampsia, chorioamnionitis, endometritis, maternal death, blood transfusion, surgical management of hemorrhage (hysterectomy, dilation & curettage, iliac artery), antibiotics, magnesium sulfate, medical treatment of hypertension, postpartum uterotonics.