ArticleReproductive health2022
Is there an optimal inter-delivery interval in women who underwent trial of labor after cesarean delivery (TOLAC)?
Article in Reproductive health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- FIGO good practice recommendations for vaginal birth after cesarean section.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Guideline
- Birth spacing and risk of adverse pregnancy and birth outcomes: A systematic review and dose-response meta-analysis.Acta obstetricia et gynecologica Scandinavica · 2023Pooled it
- "Predictors of failed vaginal birth after cesarean and associated maternal and neonatal outcomes: a case control study".BMC pregnancy and childbirth · 2026Article
- Establishment and validation of a prediction model for successful trial of labor after cesarean in scarred uteruses.American journal of translational research · 2026Article
- Development and validation of an improved prediction model for vaginal birth after previous cesarean section: a retrospective cohort study of a Chinese population.Annals of medicine · 2025Article
- The optimal childbearing age and birth spacing in china: a multicenter retrospective cohort study.BMC public health · 2025Article
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Abstract
backgroundInter-delivery interval (IDI) has been proven to be a factor associated with adverse maternal and neonatal outcomes. However, the optimal IDI in trial of labor after cesarean delivery (TOLAC) remains unclear. We aimed to investigate the association between IDI and major maternal and neonatal outcomes in women who underwent TOLAC.
methodsA multicenter, retrospective cohort study including five hospitals was conducted between January 2018 and December 2019 in Foshan, China. This study included 1080 pregnant women with one or two cesarean deliveries who attempted a TOLAC. Data on maternal and neonatal outcomes were collected from the electronic record system. Maternal and neonatal outcomes in different groups of IDI were compared by univariate and multivariable analyses.
resultsA short IDI of < 24 months did not show a statistically significant association with uterine rupture in the univariate analysis (P = 0.668). In multivariable analysis, the incidences of postpartum hemorrhage (OR 19.6, 95% CI:4.4-90.9, P < 0.05), preterm birth (OR 5.5, 95% CI:1.5-21.3, P < 0.05), and low birth weight (OR 3.5, 95% CI:1.2-10.3, P < 0.05) were significantly increased in women with an IDI of < 24 months than in those with a normal interval (24-59 months). Infection morbidity (OR 1.8, 95% CI:1.4-7.9, P < 0.05), transfusion (OR 7.4, 95% CI:1.4-40.0, P < 0.05), and neonatal unit admission (OR 2.6, 95% CI:1.4-5.0, P < 0.05) were significantly increased in women with an IDI of 120 months or more than in those with a normal interval. Postpartum hemorrhage (P = 0.062) had a trend similar to that of a significant IDI of 120 months or more. We found no statistically significant difference in maternal and neonatal outcomes between 24-59 months and 60-119 months.
conclusionsAn IDI of less than 24 months or 120 months or more increased the risk of major maternal and neonatal outcomes. We recommend that the optimal interval for women who underwent TOLAC should be 24 to 119 months.
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