The Impact of Caesarean Section in the Subsequent Pregnancy: A Retrospective Cohort Study in Vietnam

Background & Objective: The rate of Caesarean sections are increasing worldwide and may soon become the most common mode of delivery in some countries. Caesarean section is associated with short- and long-term complications, especially in subsequent pregnancies. The present study was conducted with aim to analyze the impact of caesarean section on maternal and neonatal outcomes in subsequent pregnancies.Materials & Methods: This retrospective cohort study was conducted on 5,497 women giving birth for the second time between January 2023 and December 2024. Data was collected from hospital management software at Ca Mau Obstetrics and Pediatrics Hospital, Vietnam. Data included demographic characteristics, indications for delivery, maternal and neonatal outcomes. Multivariable logistic regression models were used to determine the effect of cesarean delivery on these outcomes.Results: Women with a history of cesarean section were more likely to undergo a subsequent cesarean delivery. They also had higher risks of preterm birth, placenta previa, preeclampsia-eclampsia, premature rupture of membranes, and gestational hypertension. In addition, infants born to mothers with a prior cesarean section were at greater risk of fetal distress and low birth weight.Conclusion: These findings highlight the increased maternal and neonatal risks associated with prior caesarean section, underscoring the need to develop standardized Trial of Labor After Caesarean (TOLAC) guidelines and to promote strategies aimed at reducing unnecessary caesarean deliveries.