News | Study Finds a Two-Way Relationship Between Cesarean Delivery and Difficulty Conceiving
A new University of Bergen study found a two-way relationship between cesarean delivery and the time couples take to conceive.
Previous studies found that women with a prior cesarean delivery had more difficulty conceiving than those with a prior vaginal delivery. Many studies used the interval between pregnancies to measure fertility, but this cannot distinguish voluntary from involuntary delays.
University of Bergen researcher Yeneabeba Sima explained that pregnancy intervals cannot show whether a delay in conception was voluntary or involuntary.
Assessing Whether Pregnancy Was Planned
Sima and colleagues assessed fertility using linked data from the Norwegian Mother, Father and Child Cohort Study (MoBa) and the Medical Birth Registry of Norway (MBRN). The MoBa questionnaire asked women whether their pregnancy was planned.
Among women actively trying to conceive, the researchers examined time to pregnancy. Trying for one year or longer before pregnancy was considered reduced fertility.
The researchers examined time-to-pregnancy differences among 42,379 MoBa participants with at least one registered birth in the MBRN. Compared with women who previously delivered vaginally, those with a prior cesarean were 10% less likely to conceive during a given menstrual cycle.
Women With Fertility Problems More Likely to Have a Cesarean
The researchers also examined the association between reduced fertility and a subsequent cesarean. Among 74,025 MoBa participants, 11% reported trying for more than a year before pregnancy. Women who took one year or longer to conceive were 21% more likely to deliver by cesarean than those who conceived within 12 months.
Sima said women with difficulty conceiving had higher rates of pregnancy complications and chronic conditions such as diabetes and hypertension. However, cesarean risk remained higher even among women without these conditions.
The Association May Not Be Causal
Previous research suggested that reduced fertility after cesarean delivery might be a consequence of surgery. Sima and colleagues proposed that shared underlying risk factors may contribute to both reduced fertility and cesarean delivery.
Sima said maternal stress could plausibly link difficulty conceiving with difficult delivery and a higher risk of cesarean birth.
The findings suggest that reduced fertility observed after cesarean delivery may relate to underlying maternal conditions not recorded in the data or not yet clinically apparent, rather than being caused directly by the surgery.
News | Study Finds a Two-Way Relationship Between Cesarean Delivery and Difficulty Conceiving
News | Study Finds a Two-Way Relationship Between Cesarean Delivery and Difficulty Conceiving
A new University of Bergen study found a two-way relationship between cesarean delivery and the time couples take to conceive.
Previous studies found that women with a prior cesarean delivery had more difficulty conceiving than those with a prior vaginal delivery. Many studies used the interval between pregnancies to measure fertility, but this cannot distinguish voluntary from involuntary delays.
University of Bergen researcher Yeneabeba Sima explained that pregnancy intervals cannot show whether a delay in conception was voluntary or involuntary.
Assessing Whether Pregnancy Was Planned
Sima and colleagues assessed fertility using linked data from the Norwegian Mother, Father and Child Cohort Study (MoBa) and the Medical Birth Registry of Norway (MBRN). The MoBa questionnaire asked women whether their pregnancy was planned.
Among women actively trying to conceive, the researchers examined time to pregnancy. Trying for one year or longer before pregnancy was considered reduced fertility.
The researchers examined time-to-pregnancy differences among 42,379 MoBa participants with at least one registered birth in the MBRN. Compared with women who previously delivered vaginally, those with a prior cesarean were 10% less likely to conceive during a given menstrual cycle.
Women With Fertility Problems More Likely to Have a Cesarean
The researchers also examined the association between reduced fertility and a subsequent cesarean. Among 74,025 MoBa participants, 11% reported trying for more than a year before pregnancy. Women who took one year or longer to conceive were 21% more likely to deliver by cesarean than those who conceived within 12 months.
Sima said women with difficulty conceiving had higher rates of pregnancy complications and chronic conditions such as diabetes and hypertension. However, cesarean risk remained higher even among women without these conditions.
The Association May Not Be Causal
Previous research suggested that reduced fertility after cesarean delivery might be a consequence of surgery. Sima and colleagues proposed that shared underlying risk factors may contribute to both reduced fertility and cesarean delivery.
Sima said maternal stress could plausibly link difficulty conceiving with difficult delivery and a higher risk of cesarean birth.
The findings suggest that reduced fertility observed after cesarean delivery may relate to underlying maternal conditions not recorded in the data or not yet clinically apparent, rather than being caused directly by the surgery.
Source:
Collected online