Brief Report: Cesarean Delivery and Subsequent Fecundability

Area of Science:

• Reproductive Health
• Obstetrics
• Perinatal Epidemiology

Background:

• Cesarean delivery is linked to fewer subsequent births, but reasons are unclear.
• Previous studies did not fully account for pregnancy intention or surgical indications.
• This study investigates cesarean delivery's impact on subsequent fecundability.

Purpose of the Study:

• To evaluate the association between cesarean delivery and subsequent fecundability.
• To analyze how delivery type and fetal presentation affect fertility after childbirth.

Main Methods:

• Cohort study of 910 primiparous Danish women (2007-2012).
• Obstetrical history from registry linkage; time-to-pregnancy via questionnaire.
• Fecundability ratios (FRs) adjusted for confounders.

Main Results:

• Emergency cesarean delivery (cephalic presentation) showed no significant impact on fecundability (FR = 1.0).
• Cesarean delivery for breech presentation reduced fecundability (FR = 0.72).
• Planned cesarean delivery (cephalic presentation) significantly reduced fecundability (FR = 0.51).

Conclusions:

• The association between cesarean delivery and subsequent fecundability depends on fetal presentation and delivery circumstances.
• Breech presentation and planned cesarean delivery are associated with lower fertility for subsequent pregnancies.