Clin Case Rep Int | Volume 7, Issue 1 | Research Article | Open Access

Influence of Previous Cesarean Section on Subsequent Pregnancy Complications in Hunan, China: A Retrospective Cohort Study

Owusua T1*, Liu M3, Huang C3, Hu H3, Lu J2 and Qin C2,3

1Catholic University of Ghana, Fiapre, Ghana
2Department of Health and Nursing Management, The Third Xiangya Hospital of Central South University, China
3School of Nursing, Central South University, Hunan, China

*Correspondance to: Theresah Owusua 

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Aim: Under the introduction of the two-child policy, women with second pregnancies having a previous cesarean section have suddenly increased. The two-child policy has provided a new chance for studying the previous cesarean section, which is considered a new medical risk in China. This study aimed to examine the previous cesarean sections influence on pregnancy complications among women with singleton delivery in their second pregnancies. Method: A total of 2018 eligible women with second pregnancies who had a singleton delivery from January 2015 to October 2017 were studied retrospectively. Data on the previous delivery mode for the first pregnancy, maternal characteristics and pregnancy complications for the second pregnancy were obtained from the electronic medical records. Chi-square test was used to describe and obtain the significant maternal characteristics according to the previous mode of delivery. The pregnancy complications associated with previous cesarean section was analyzed with binary logistic regression. Results: Of 2018 eligible women with singleton delivery in their second pregnancy, 942 (46.7%) had a previous cesarean section (study group) while 1076 (53.3%) also had a previous vaginal delivery (reference group). Previous cesarean section had an increase risk on the following pregnancy complications; Gestational Diabetes Mellitus (GDM) (Adjusted Odds Ratio [aOR]: 1.438; 95% CI, 1.093-1.894), fetal anomaly (aOR: 14.258; 95% CI, 4.213-48.248), and placenta previa (aOR: 2.890; 95% CI, 1.623-5.148). Conclusion: This study demonstrates that the previous cesarean section is associated with increased risk of GDM, fetal anomaly and placenta previa on second singleton pregnancy after the implementation of the universal two-child policy in China.


Cesarean section; China; Pregnancy complications; Second pregnancy; Two-child policy


Owusua T, Liu M, Huang C, Hu H, Lu J, Qin C. Influence of Previous Cesarean Section on Subsequent Pregnancy Complications in Hunan, China: A Retrospective Cohort Study. Clin Case Rep Int. 2023; 7: 1509.

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