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Updated: Jan 1, 2026

External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Risk of preterm birth after prior term cesarean
L Visser1, C Slaager2, B M Kazemier3
1Department of Obstetrics and Gynaecology Located at the Boelelaan, Amsterdam University Medical Centre, Amsterdam, the Netherlands.
Objective:
To determine the risk of overall preterm birth (PTB) and spontaneous PTB in a pregnancy after a caesarean section (CS) at term.
Design:
Longitudinal linked national cohort study.
Setting:
The Dutch Perinatal Registry (1999-2009).
Population:
268 495 women with two subsequent singleton pregnancies were identified.
Methods:
A cohort study based on linked registered data from two subsequent pregnancies in the Netherlands.
Main Outcome Measures:
The incidence of overall PTB and spontaneous PTB with subgroup analysis on gestational age at first delivery and type of CS (planned or unplanned).
Results:
Of 268 495 women with a singleton first pregnancy who delivered at term, 15.76% (n = 42 328) had a CS. The incidence of PTB in the second pregnancy was 2.79% (n = 1182) in women with a previous CS versus 2.46% (n = 5570) in women with a previous vaginal delivery (adjusted odds ratio [aOR] 1.14, 95% confidence interval [CI] 1.07-1.21). This increased risk is mainly driven by an increased risk of spontaneous PTB after previous CS at term (aOR 1.50, 95% CI 1.38-1.70). Analysis for type of CS compared with vaginal delivery showed an aOR on spontaneous PTB of 1.86 (95% CI 1.58-2.18) for planned CS and an aOR of 1.40 (95% CI 1.24-1.58) for unplanned CS.
Conclusions:
CS at term is associated with a marginally increased risk of spontaneous PTB in a subsequent pregnancy.
Tweetable Abstract:
Caesarean section at term is associated with a marginally increased risk of spontaneous PTB in a subsequent pregnancy.
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