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Hum. Reprod. Advance Access originally published online on January 23, 2008
Human Reproduction 2008 23(3):543-547; doi:10.1093/humrep/dem428
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Pregnancy after Caesarean section: fewer or later?

J.J.H. Eijsink1,2, L. van der Leeuw-Harmsen1 and P.J.Q. van der Linden1,3

1 Department of Obstetrics and Gynaecology, Deventer Ziekenhuis, PO Box 5001, Deventer 7400 GC, The Netherlands 2 Present address: Department of Obstetrics and Gynaecology, University Medical Centre Groningen, PO Box 30.001, Groningen 9700 RB, The Netherlands

3 Correspondence address. Tel: +31-570-646741; Fax: +31-570-646746; E-mail: p.j.q.vanderlinden{at}dz.nl

BACKGROUND: It is unclear whether having a Caesarean section results in fewer subsequent pregnancies with longer intervals between pregnancies, an effect which may impact on the reproductive performance of a population. Our aim was to determine the implications of a Caesarean section on the subsequent fecundity and interpregnancy interval.

METHODS: This is a cohort study. The obstetric follow-up of primiparous women who delivered by a Caesarean section of a singleton infant in breech presentation is compared with the follow-up of women who delivered vaginally of a singleton infant after a physiological, uncomplicated pregnancy.

RESULTS: A total of 279 women delivered a singleton infant in breech presentation at term. From these women, 165 (59.1%) had a Caesarean section. In this group, 131 (79.4%) women had a subsequent pregnancy. In the reference group of 268 women who delivered vaginally, 208 (77.6%) became pregnant again. The median interval between birth of the first child and the beginning of the next pregnancy was 20 months for the Caesarean section group and 18 months for the reference group. No significant difference in interpregnancy interval between the different groups was found.

CONCLUSIONS: Women who delivered by Caesarean section at term in their first pregnancy do not have fewer second pregnancies compared with women who delivered vaginally. The interpregnancy interval between first and second pregnancy was not prolonged.

Key words: Caesarean section/interpregnancy interval/subsequent pregnancy/mode of delivery/fecundity

Submitted on June 27, 2007; resubmitted on December 6, 2007; accepted on December 13, 2007.


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