Correlation Between Previous Caesarean Section and Adverse Maternal Outcomes Accordingly With Robson Classification: Systematic Review and Meta-Analysis

Shazia Jamshed, Shuo-Chen Chien, Afifa Tanweer, Rahma-Novita Asdary, Muhammad Hardhantyo, David Greenfield, Chia-Hui Chien, Shuen-Fu Weng, Wen-Shan Jian, Usman Iqbal

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)

Abstract

Background: The increasing rates of Caesarean section (CS) beyond the WHO standards (10–15%) pose a significant global health concern.Objective: Systematic review and meta-analysis to identify an association between CS history and maternal adverse outcomes for the subsequent pregnancy and delivery among women classified in Robson classification (RC).Search Strategy: PubMed/Medline, EbscoHost, ProQuest, Embase, Web of Science, BIOSIS, MEDLINE, and Russian Science Citation Index databases were searched from 2008 to 2018.Selection Criteria: Based on Robson classification, studies reporting one or more of the 14 adverse maternal outcomes were considered eligible for this review.Data Collection: Study design data, interventions used, CS history, and adverse maternal outcomes were extracted.Main Results: From 4,084 studies, 28 (n = 1,524,695 women) met the inclusion criteria. RC group 5 showed the highest proportion among deliveries followed by RC10, RC7, and RC8 (67.71, 32.27, 0.02, and 0.001%). Among adverse maternal outcomes, hysterectomy had the highest association after preterm delivery OR = 3.39 (95% CI 1.56–7.36), followed by Severe Maternal Outcomes OR = 2.95 (95% CI 1.00–8.67). We identified over one and a half million pregnant women, of whom the majority were found to belong to RC group 5.Conclusions: Previous CS was observed to be associated with adverse maternal outcomes for the subsequent pregnancies. CS rates need to be monitored given the prospective risks which may occur for maternal and child health in subsequent births.
Original languageEnglish
Article number740000
JournalFrontiers in Medicine
Volume8
DOIs
Publication statusPublished - Jan 10 2022

Keywords

  • World Health Organisation - Robson Classification
  • adverse maternal outcomes
  • global health
  • previous caesarean section
  • public health practice
  • women's health

ASJC Scopus subject areas

  • General Medicine

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