Document Detail

Cocaine use during pregnancy and the failure of vaginal birth after cesarean.
MedLine Citation:
PMID:  16363754     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the failure rate of a trial of vaginal birth in women with singleton pregnancies and 1 prior cesarean section who reported using cocaine during the current pregnancy. STUDY DESIGN: The medical records of 9254 women who attempted a vaginal birth after cesarean (VBAC) at 16 community and tertiary care hospitals were retrospectively reviewed. VBAC was considered a failure if a woman who was initially considered suited to a trial of VBAC for whatever reason did not succeed in vaginal delivery and had to undergo a repeat cesarean section. We used stratified analysis as well as forward and backward logistic regression analysis to assess the relation between cocaine use during pregnancy and VBAC failure. RESULTS: Thirteen percent of patients who reported using cocaine had a significant 59% decrease in the odds for VBAC failure in the unadjusted analysis (OR = 0.41, 95% CI= 0.29-0.58) as compared to those who did not report using this substance. Nevertheless, after adjusting for other important predictors of failure and possible confounding variables, the use of cocaine in our final model showed no difference in the odds for VBAC failure (OR = 0.74, 95% CI = 0.49-1.13) as compared to the odds in women who did not report using the drug. CONCLUSION: We could not find any statistically significant difference in the odds for VBAC failure between patients who reported cocaine use during pregnancy and patients who reported those who did not.
Bruno F Casanova; Mary D Sammel; George A Macones
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  50     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-12-20     Completed Date:  2006-02-07     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  663-8     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Pennsylvania Hospital, University of Pennsylvania, 800 Spruce Street, Philadelphia, PA 19107, USA.
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MeSH Terms
Cesarean Section
Cesarean Section, Repeat / statistics & numerical data*
Cocaine-Related Disorders / complications*
Labor, Obstetric
Obstetric Labor Complications / etiology*
Pregnancy Outcome
Retrospective Studies
Trial of Labor
Vaginal Birth after Cesarean / statistics & numerical data*
Grant Support
D43-TW01272/TW/FIC NIH HHS; K24 HD01289/HD/NICHD NIH HHS; R01-H035631//PHS HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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