Neonatal outcomes following a trial of labor after Caesarean delivery: a population-based study

AbstractPurpose: To evaluate the neonatal effects of trial of labor after Caesarean (TOLAC) births.Methods: We conducted a retrospective population-based cohort study using the CDC’s Period Linked Birth/Infant Death Public Use File (2011–2013) on women with a live singleton pregnancy and prior Caesarean delivery. Multivariate logistic regression compared neonatal outcomes between women who underwent a TOLAC with women who did not. Secondary analysis compared outcomes of birth with uterine rupture to those without.Results: A total of 1,036,554 births met inclusion criteria, of which 17.5% underwent TOLAC. Women who had a TOLAC were more likely to deliver infants requiring neonatal intensive care unit (NICU) admission (odds ratios (OR) 1.12, 95%CI 1.09–1.16) and assisted ventilation (OR 1.07, 95%CI 1.03–1.12). Among women with TOLAC, 0.18% of births were in context of a uterine rupture and those neonates had an increased risk of NICU admissions (OR 5.95, 95%CI 4.56–7.76), assisted ventilation (OR 8.89, 95%C...