Factors associated with vaginal birth after cesarean in a maternity hospital of Rio de Janeiro

Objectives: Identifying characteristics associated with vaginal birth after cesarean. Study design: Case-control study based on medical records. Study population: women with previous cesarean, who had delivered in a public Rio de Janeiro maternity hospital between 1992 and 1996. Sample: 141 cases (vaginal births after cesarean) and 304 controls (a new cesarean after other(s)). Multivariate analysis with logistic regression was carried out. Results: The following characteristics were associated with greater probability of vaginal birth (IC=95%): only one previous cesarean (OR=19.05; IC=6.88–52.76); cervical dilatation at admission above 3 cm (OR=8.86; IC=4.93–15.94); gestational age below 37 weeks (OR=3.01; IC=1.40–6.46); history of at least one previous vaginal birth (OR=2.12; IC=1.18–3.82); level of education below high school (OR=1.94; IC=1.02–3.69). Chronic hypertension reduced the chances of vaginal birth (OR=0.44; IC=0.22–0.88). Conclusions: Among the factors that can be modified to reduce the number of repeated cesareans are: trial of labor promotion, reducing admission of women at early stages of labor and adequate hypertension management during pregnancy. Condensation: Among the factors that can be modified to reduce the number of repeated cesareans are: the trial of labor promotion for women who present previous cesarean, reducing admission of women at early stages of labor and adequate hypertension management during pregnancy.