Previous term emergency caesarean section is a risk factor for recurrent spontaneous preterm birth; a retrospective cohort study

•The association between prior term EMCS and recurrent sPTB is determined.•54% of women who had a prior term EMCS followed by a sPTB, had a recurrent sPTB.•There is a high risk of recurrent sPTB in women who have had a sPTB after a term EMCS. Emergency caesarean sections (EmCS), particularly those performed in the second stage of labour, have been associated with a risk of subsequent preterm birth. More worrying is that the risk of sPTB recurrence appears to be high in women who have had a second stage EmCS and a subsequent sPTB. However, there is a paucity of evidence regarding the risk of recurrence in women who have had a prior term EmCS at any stage of labour followed by a sPTB. This study aims to investigate the relationship between all term in labour EmCS and the risk of recurrent spontaneous preterm birth (sPTB). Study Design. This is an observational, retrospective cohort study conducted at St Thomas’ Hospital, a tertiary-level maternity hospital in London, United Kingdom. 259 women were included; 59 women with a term in labour EmCS preceding a sPTB (EmCS group) and 200 women with a prior sPTB only (control group). The initial EmCS was further categorised into first stage (FS)-EmCS or second stage (SS)-EmCS. Primary outcome was sPTB in Pregnancy C