The Effect of Prematurity on Vaginal Birth After Cesarean Delivery: Success and Maternal Morbidity
Bibliographic record
Abstract
OBJECTIVE: We sought to compare vaginal birth after cesarean (VBAC) success and uterine rupture rates between preterm and term gestations in women with a history of one prior cesarean delivery. Our hypothesis was that preterm women undergoing VBAC were more likely to be successful and have a lower rate of complications than term women undergoing VBAC. METHODS: We reviewed medical records of women with a history of a cesarean delivery who either attempted a VBAC or underwent a repeat cesarean delivery from 1995 through 2000 in 17 community and university hospitals. We collected information on demographics, medical and obstetric history, complications, and outcome of the index pregnancy. The primary analysis was limited to women with singleton gestations and one prior cesarean delivery. Statistical analysis consisted of bivariate and multivariable techniques. RESULTS: Among the 20,156 patients with one prior cesarean delivery, 12,463 (61%) attempted a VBAC. Mean gestational ages for the term and preterm women were 39.2 weeks and 33.9 weeks of gestation, respectively. The VBAC success rates for the term and preterm groups were 74% and 82%, respectively (P < .001). Multivariable analysis showed that the VBAC success was higher (adjusted odds ratio 1.54, 95% confidence interval 1.27-1.86) in preterm gestations. A decreased risk of rupture among preterm gestations was suggested in these results (adjusted odds ratio 0.28, 95% confidence interval 0.07-1.17; P = .08). CONCLUSION: Preterm patients undergoing a VBAC have higher success rates when compared with term patients undergoing a VBAC. Preterm patients undergoing VBAC may have lower uterine rupture rates.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".