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Healthcare utilisation, induced labour and caesarean section in the pregnancy after stillbirth: a prospective study
Author(s) -
Gravensteen IK,
Jacobsen EM,
Sandset PM,
Helgadottir LB,
Rådestad I,
Sandvik L,
Ekeberg Ø
Publication year - 2018
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.14750
Subject(s) - medicine , obstetrics , childbirth , caesarean section , pregnancy , odds ratio , cohort study , population , live birth , norwegian , gynecology , genetics , environmental health , pathology , biology , linguistics , philosophy
Objective To investigate healthcare utilisation, induced labour and caesarean section ( CS ) in the pregnancy after stillbirth and assess anxiety and dread of childbirth as mediators for these outcomes. Design Population‐based pregnancy cohort study. Setting The Norwegian Mother and Child Cohort Study. Sample A total of 901 pregnant women; 174 pregnant after stillbirth, 362 pregnant after live birth and 365 previously nulliparous. Methods Data from questionnaires answered in the second and third trimesters of pregnancy and information from the Medical Birth Registry of Norway. Main outcome measures Self‐reported assessment of antenatal care, register‐based assessment of onset and mode of delivery. Results Women with a previous stillbirth had more frequent antenatal visits (mean 10.0; 95% CI 9.4–10.7) compared with women with a previous live birth (mean 6.0; 95% CI 5.8–6.2) and previously nulliparous women (mean 6.3; 95% CI 6.1–6.6). Induced labour and CS , elective and emergency, were also more prevalent in the stillbirth group. The adjusted odds ratio for elective CS was 2.5 (95% CI 1.3–5.0) compared with women with previous live birth and 3.7 (1.8–7.6) compared with previously nulliparous women. Anxiety was a minor mediator for the association between stillbirth and frequency of antenatal visits, whereas dread of childbirth was not a significant mediator for elective CS . Conclusions Women pregnant after stillbirth were more ample users of healthcare services and more often had induced labour and CS . The higher frequency of antenatal visits and elective CS could not be accounted for by anxiety or dread of childbirth. Tweetable abstract Women pregnant after stillbirth are ample users of healthcare services and interventions during childbirth.