Impact of caesarean section on mode of delivery, pregnancy-induced and pregnancy-associated disorders, and complications in the subsequent pregnancy in Germany

We analyzed the impact of caesarean section (CS) on mode of delivery, pregnancy-induced/associated disorders and complications in the subsequent pregnancy within German gynecological practices. 1,801 women with CS and 1,801 matched women with vaginal delivery (VD) were included. Cox regressions were used to determine the influence of CS with regard to these disorders. Medical abortion and single spontaneous delivery were significantly less frequent in CS than in VD women, whereas CS after CS was the significantly more common mode of delivery. Gestational hypertension without significant proteinuria, gestational hypertension with significant proteinuria, and polyhydramnios were more frequent in women with CS than in women with VD. Hemorrhage and maternal care for known or suspected disproportion were more common in the CS group than in the VD group. CS women were more likely to undergo further CS and to develop major pregnancy-associated diseases in the following pregnancy compared to VD women.