(HealthDay News) — Birth by cesarean section may increase the risk of subsequent stillbirth or ectopic pregnancy, according to research published online July 1 in PLOS Medicine.

Sinead M. O’Neill, MPH, of Cork University in Ireland, and colleagues performed a population-based cohort study using data for 832,996 live births from the 1982–2010 Danish national registry. The authors sought to assess the association between primary cesarean and the rates of subsequent stillbirth, miscarriage, and ectopic pregnancy.

The researchers found that women who had a primary cesarean section, compared with those who gave birth by spontaneous vaginal delivery, had increased rates of stillbirth (hazard ratio [HR], 1.14; 95% confidence interval [CI], 1.01–1.28) and ectopic pregnancy (HR, 1.09; 95% CI, 1.04–1.15) in subsequent pregnancies. Among women with primary cesarean section, no increased rate of miscarriage was observed, and maternally requested cesarean was associated with a decreased rate of miscarriage (HR, 0.72; 95 percent CI, 0.60–0.85).

“This study found that cesarean section is associated with a small increased rate of subsequent stillbirth and ectopic pregnancy,” the authors write. “Underlying medical conditions, however, and confounding by indication for the primary cesarean delivery account for at least part of this increased rate.”

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