Study on demographic and sociological factors influencing the outcome of vaginal trial of labor for subsequent pregnancies after cesarean section
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Objective To explore the demographic and sociological factors influencing the outcome of trial of labor after cesarean (TOLAC) during subsequent pregnancy, aimed at improving the success rate of TOLAC. Methods Adopting a prospective nested case-control study.Follow up on the vaginal trial outcomes of 562 pregnant women with scar uterus who met the inclusion criteria.132 cases of scarred uterus transferred to cesarean section were included in the study group and 430 scarred uterus cases of successful vaginal delivery were included in the control group.Compare the differences between the two groups in demographic sociology and obstetric conditions and further conduct correlation analysis on indicators with statistical differences between groups. Results Single factor comparison between groups showed statistical differences between the two groups in terms of education level, vaginal delivery history over 28 weeks, natural labor, cervical score, and intraspinal delivery analgesia (P<0.05).There was no statistically significant difference in age and ethnicity(P>0.05).Multivariate logistic regression analysis showed a negative correlation between educational level and vaginal trial delivery failure in scarred uterus pregnancy (OR=0.692, P<0.05),The negative correlation was discovered between known confounding factors (≥ 28 weeks of vaginal delivery history, natural labor, cervical score, intraspinal delivery analgesia) and TOLAC failure(P<0.05) . There was no interaction between educational level and the various known confounding factors included (OR=1, P>0.05) . Conclusion Educational level is an independent factor affecting the outcome of TOLAC, and there is a negative correlation between educational level and TOLAC failure.Therefore,it is necessary to strengthen scientific education, psychological guidance, and psychological support for pregnant women with scarred uterus who have lower educational level in order to improve the success rate of TOLAC.
