LONG-TERM EFFECTS OF CESAREAN-SECTIONS - ECTOPIC PREGNANCIES AND PLACENTAL PROBLEMS

OBJECTIVE: Few studies on the long-term effects of cesarean sections e xist. The purpose of this study was to investigate the occurrence of t hree long-term effects, ectopic pregnancy, placenta previa, and abrupt io placentae, in the subsequent pregnancy. STUDY DESIGN: This retrospe ctive cohort study was based on two nationwide registers in Finland: t he birth register and the hospital inpatient register. Women (n = 16,9 38) having had a cesarean section (exposed women) and a matched contro l group were identified from the birth register. The occurrence and ou tcome of the first subsequent pregnancy was determined from the 1987 t o 1993 hospital inpatient register and the first subsequent birth from the 1987 to 1993 birth register. RESULTS: During the follow-up time i n the hospital inpatient register, fewer exposed women had a completed pregnancy. Ectopic pregnancy was more common among the exposed women than among the controls (risk ratio 1.28). In the first subsequent bir th abruptio placentae was more common among primiparous (at index the birth, risk ratios of 3.22 in hospital inpatient register and 2.41 in birth register) and multiparous women (4.52 in hospital inpatient regi ster and 3.89 in birth register). Placenta previa was more common amon g primiparous exposed women than among control women (risk ratio 5.34 in hospital inpatient register and 3.78 in birth register). CONCLUSION S: Cesarean section is a modest risk factor for ectopic pregnancy and an important risk factor for placental problems.