Influence of Cesarean Section on Postpartum Fertility and Dysmenorrhea: A Retrospective Cohort Study in Japan

Objective: To investigate the association between cesarean section (CS) and postpartum fertility and dysmenorrhea using data from a Japanese insurance registry. Methods: This retrospective cohort study used a data set of patients registered between 2007 and 2021 in an insurance registry comprising s...

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Main Authors: Mizuki Ohashi (Author), Shunichiro Tsuji (Author), Kyoko Kasahara (Author), Ryoko Oe (Author), Yumiko Tateoka (Author), Takashi Murakami (Author)
Format: Book
Published: Mary Ann Liebert, 2024-01-01T00:00:00Z.
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001 doaj_830da01c35d2407a811d7da00ecb7faa
042 |a dc 
100 1 0 |a Mizuki Ohashi  |e author 
700 1 0 |a Shunichiro Tsuji  |e author 
700 1 0 |a Kyoko Kasahara  |e author 
700 1 0 |a Ryoko Oe  |e author 
700 1 0 |a Yumiko Tateoka  |e author 
700 1 0 |a Takashi Murakami  |e author 
245 0 0 |a Influence of Cesarean Section on Postpartum Fertility and Dysmenorrhea: A Retrospective Cohort Study in Japan 
260 |b Mary Ann Liebert,   |c 2024-01-01T00:00:00Z. 
500 |a 10.1089/WHR.2023.0109 
500 |a 2688-4844 
520 |a Objective: To investigate the association between cesarean section (CS) and postpartum fertility and dysmenorrhea using data from a Japanese insurance registry. Methods: This retrospective cohort study used a data set of patients registered between 2007 and 2021 in an insurance registry comprising specific employee-based health insurance companies in Japan. Of those data sets, we included data from participants who had their first recorded childbirth between 2014 and 2018. The exclusion criteria were any prior deliveries, dysmenorrhea, or complications that would affect the next pregnancy or postpartum dysmenorrhea since 2007. The occurrence of subsequent childbirth and postpartum dysmenorrhea until 2021 was compared between the CS and vaginal delivery (VD) groups using the log-rank test and Cox proportional hazards model with stratification according to age and age matching. Results: This study included 25,984 (5,926 after age matching) and 5,926 participants in the VD and CS groups, respectively. After age matching, the rate of subsequent childbirth was 18.3% and 16.3%, and the rate of postpartum dysmenorrhea was 6.5% and 7.8% in the VD and CS groups, respectively. There were fewer subsequent childbirths in the CS group than in the VD group after age matching in the stratified Cox proportional hazards model (hazard ratio [HR] 95% confidence interval [CI]: 0.86 [0.79?0.94]). The CS group had a significantly higher risk of dysmenorrhea (HR [95% CI]: 1.18 [1.03?1.36]). Conclusions: Although confounding might be existing, our study suggests that CS might be associated with decreased postpartum fertility and increased dysmenorrhea. The medical indications for CS should be carefully determined; post-CS women should be meticulously followed up. 
546 |a EN 
690 |a cesarean section 
690 |a dysmenorrhea 
690 |a maternal fertility 
690 |a retrospective study 
690 |a secondary infertility 
690 |a Gynecology and obstetrics 
690 |a RG1-991 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n Women's Health Reports, Vol 5, Iss 1, Pp 22-29 (2024) 
787 0 |n https://www.liebertpub.com/doi/full/10.1089/WHR.2023.0109 
787 0 |n https://doaj.org/toc/2688-4844 
856 4 1 |u https://doaj.org/article/830da01c35d2407a811d7da00ecb7faa  |z Connect to this object online.