Grand multiparity, is it a help or a hindrance in a trial of labor after cesarean section (TOLAC)?

Figures & data

Table 1. Demographic characteristics across the groups.

Variable	Group 1	Group 2	Group 3	p Value
Number	879	2374	2194
Maternal age (years)	27.61 ± 4.6	30.23 ± 4.1	36.00 ± 3.9	.001
Gestational age at delivery (weeks)	39.52 ± 1.3	39.43 ± 1.4	39.45 ± 1.5	.584
VBAC (n)^a	0.00 ± 0	1.19 ± 1	2.91 ± 2.4	.01

Continuous variable reported as means ± standard deviation.

^a VBAC: vaginal birth after cesarean delivery.

Figure 1. Combined adverse outcome according to group.

Table 2. Maternal and neonatal outcomes among the groups.

	N	Group 1 vs. group 2	Group 2 vs. group 3	Group 1 vs. group 3
	Odds ratio + 95% confidence interval+p Value
Failed TOLAC
Group 1	171 (19.5%)	OR 5.01 (3.9, 6.5) p < .001	OR 1.03 (0.8, 1.4) p = .89	OR 5.17 (3.9, 6.7) p = .83
Group 2	109 (4.6%)
Group 3	98 (4.5%)
OVD
Group 1	221 (25.1%)	5.13 (4.1, 6.4) p = 0	1.78 (1.3, 2.4) p = 0	OR 9.2 (7.0, 12.1) p < .001
Group 2	146 (6.2%)
Group 3	78 (3.5%)
PPH
Group 1	26 (3%)	OR 1.7 (1.07, 2.85) p = .03	OR 0.7 (0.7, 1.7) p = .7	OR 2.22 (1.3, 3.7) p = .002
Group 2	40 (1.7%)
Group 3	34 (1.6%)
Uterine rupture
Group 1	9 (1.0%)	3.47 (1.3, 9.3) p = .02	1.3 (0.4, 4.0) p = .78	OR 4.32 (1.5, 14.5) p = .007
Group 2	7 (0.29%)
Group 3	5 (0.23%)
pH  <  7.1 (n)
Group 1	18 (2%)	4.86 (2.25, 10.49) p < .001	1.3 (0.5, 3.46) p = .63	OR 6.68 (2.9, 17.5) p < .001
Group 2	10 (0.4%)
Group 3	7 (0.3%)
Apgar 5  <  7 (n)
Group 1	9 (1%)	OR 2.4 (0.99, 6.03) p = .08	OR 0.92 (0.38, 2.22) p = .7	OR 2.01 (0.8, 5.1) p = .123
Group 2	10 (0.4%)
Group 3	10 (0.5%)