Mode of First Delivery and Subsequent Child-Bearing

项目摘要/摘要 之前在美国和其他国家进行的研究发现，第一次分娩的女性 剖腹产的孩子比剖腹产的孩子更不可能生育后续的孩子，并且后续生育的孩子更少 通过阴道分娩第一个孩子的妇女。然而，几乎所有这些研究都是回溯性分析 现有的数据集，或对第一次分娩后数年的妇女的调查。因此，尚不清楚女性是否 通过剖腹产分娩第一个孩子的妇女与之前通过阴道分娩的妇女不同 第一次分娩的方式既使她们倾向于要求剖腹产，又使她们不太可能 想要或能够怀孕并生育一个或多个后续子女，或者如果有什么关于 剖腹产本身会影响妇女怀孕或生育后代的意愿或能力。vt.给出 最近美国和世界各国剖腹产率的增加，是 重要的是设计良好的、仔细进行的、前瞻性的、有足够统计数据的纵向研究 进行权力，以提高对剖腹产增加的程度的科学知识 妇女随后不孕的风险，如果是，原因是什么。这项关于生育的前瞻性纵向研究 与第一次分娩方式相关的模式是对增加妇女患糖尿病风险的两个因素的调查 剖宫产分娩第一胎及一次剖宫产对母婴的影响 结果，包括随后的生育。这项研究的具体目的是：1)先测量Pre-first 不同样本2790名孕妇的分娩意愿和生育意向 访谈旨在评估分娩前的因素，这些因素可以解释随后的剖宫产术后缺陷 生育，2。)2790例住院病历中产程及分娩相关因素测评 可以解释剖腹产后生育缺陷的女性，以及3。要确定影响 通过一项为期3年的前瞻性纵向研究，研究初次剖腹产对后续生育的影响 2790名妇女，在第一次分娩后1、6、12、18、24、30和36个月进行评估，比较 对那些通过阴道分娩的人，考虑到剖腹产前的因素，通过剖腹产进行分娩 接生面谈和医院病历。项目叙事 在过去的十年里，美国的剖腹产率急剧上升，超过一百万 妇女每年通过剖腹产分娩。这项研究将调查剖腹产的程度 增加妇女继发不孕的风险，并将显著改善目前的科学水平 关于这个问题的知识。

Project summary/abstract Previous studies, conducted both in the US and other countries, have found that women who deliver their first child by cesarean section are less likely to bear subsequent children and bear fewer subsequent children than women who deliver their first child vaginally. However, nearly all of these studies were retrospective analyses of existing data sets, or surveys of women years after their first delivery. Consequently, it is not clear if women who deliver their first child via cesarean section are different from women who deliver vaginally prior to the first delivery in ways that both predispose them to require delivery by cesarean section and to be less likely to want to or be able to conceive and bear one or more subsequent children, or if there is something about the cesarean section itself that affects women's desire or ability to conceive or bear subsequent children. Given the recent increase in the rate of cesarean section in the US and in countries throughout the world, it is essential that well-designed, carefully conducted, prospective, longitudinal studies with adequate statistical power be conducted to improve scientific knowledge of the extent to which cesarean section increases a woman's risk of subsequent infertility, and if so, why. This prospective, longitudinal study of child-bearing patterns in relation to mode of first delivery is an investigation of both factors that increase a woman's risk of delivering her first child by cesarean section, and the effects of primary cesarean delivery on important outcomes, including subsequent child-bearing. The specific aims of this study are: 1.) To measure pre-first delivery child-bearing desires and intentions among a diverse sample of 2790 pregnant women through interviews designed to assess pre-delivery factors that could explain post-cesarean deficits in subsequent child-bearing, 2.) To measure labor and delivery related factors in the hospital medical records of these 2790 women that could explain post-cesarean deficits in subsequent child-bearing, and 3.) To determine the effects of primary cesarean delivery on subsequent childbearing, via a 3-year prospective, longitudinal study of these 2790 women, with assessments at 1, 6, 12, 18, 24, 30 and 36 months post first delivery, comparing those who deliver by cesarean section to those who deliver vaginally, taking into account factors measured in the pre- delivery interview and the hospital medical records. Project Narrative The rate of cesarean delivery in the US has increased dramatically in the past decade and more than a million women deliver by cesarean section annually. This study will investigate the extent to which cesarean delivery increases a woman's risk of subsequent infertility and will substantially improve the current level of scientific knowledge about this issue.