Table 3:

Neonatal death and serious neonatal morbidity, by type of delivery*

OutcomeNo. of birthsRate per 1000 deliveriesCrude RR (95% CI)Adjusted RR (95% CI)
Neonatal death
Elective repeat cesarean110.081.00 (Ref.)1.00 (Ref.)
Attempted VBAC120.222.58 (1.14 to 5.84)2.32 (0.99 to 5.48)
 Successful VBAC< 5< 0.181.71 (0.55 to 8.57)1.46 (0.45 to 4.78)
 Failed VBAC80.293.45 (1.39 to 8.57)3.22 (1.26 to 8.24)
Assisted ventilation
Elective repeat cesarean183514.01.00 (Ref.)1.00 (Ref.)
Attempted VBAC111120.01.44 (1.33 to 1.55)1.49 (1.38 to 1.62)
 Successful VBAC40014.31.03 (0.92 to 1.14)1.08 (0.96 to 1.20)
 Failed VBAC71125.61.86 (1.70 to 2.03)1.88 (1.72 to 2.06)
Assisted ventilation excluding CPAP
Elective repeat cesarean3963.011.00 (Ref.)1.00 (Ref.)
Attempted VBAC3626.502.17 (1.88 to 2.50)2.15 (1.85 to 2.49)
 Successful VBAC1184.221.40 (1.14 to 1.73)1.38 (1.12 to 1.71)
 Failed VBAC2448.792.94 (2.50 to 3.45)2.87 (2.44 to 3.39)
Neonatal seizures
Elective repeat cesarean790.601.00 (Ref.)1.00 (Ref.)
Attempted VBAC771.382.30 (1.68 to 3.15)2.30 (1.65 to 3.19)
 Successful VBAC301.071.79 (1.17 to 2.72)1.78 (1.15 to 2.76)
 Failed VBAC471.692.82 (1.97 to 4.05)2.77 (1.91 to 4.01)
Respiratory distress syndrome
Elective repeat cesarean723155.01.00 (Ref.)1.00 (Ref.)
Attempted VBAC269948.50.88 (0.84 to 0.92)0.90 (0.86 to 0.94)
 Successful VBAC103236.90.66 (0.62 to 0.70)0.68 (0.63 to 0.72)
 Failed VBAC166760.11.10 (1.04 to 1.16)1.12 (1.06 to 1.18)
Neonatal mortality and morbidity
Elective repeat cesarean190314.51.00 (Ref.)1.00 (Ref.)
Attempted VBAC115720.81.45 (1.34 to 1.56)1.49 (1.38 to 1.61)
 Successful VBAC42015.01.04 (0.93 to 1.16)1.08 (0.97 to 1.21)
 Failed VBAC73726.61.86 (1.71 to 2.03)1.88 (1.72 to 2.05)
Restricted mortality and morbidity
Elective repeat cesarean4693.571.00 (Ref.)1.00 (Ref.)
Attempted VBAC4157.452.10 (1.84 to 2.40)2.07 (1.81 to 2.38)
 Successful VBAC1405.011.41 (1.16 to 1.70)1.38 (1.13 to 1.68)
 Failed VBAC2759.912.80 (2.41 to 3.25)2.73 (2.34 to 3.19)
  • Note: CI = confidence interval, CPAP = continuous positive airway pressure, RR = rate ratio, VBAC = vaginal birth after cesarean.

  • * There were 131 493 elective repeat cesarean births, 55 691 attempted VBAC births, 27 947 successful VBAC births and 27 744 failed VBAC births without congenital anomalies. Our study was restricted to women with a parity of 1 who had a previous cesarean delivery and who delivered a singleton at 37 to 43 weeks gestation in the current pregnancy in Canada (excluding Quebec) from 2003 to 2014. Births with congenital anomalies were excluded.

  • Logistic models included maternal age, diabetes mellitus, hypertension and labour induction.

  • Neonatal mortality and morbidity included neonatal death, neonatal seizures and assisted ventilation including CPAP.

  • Restricted mortality and morbidity included neonatal death, neonatal seizures and assisted ventilation not including CPAP.