White's classification of maternal diabetes and vaginal birth after cesarean delivery success in women undergoing a trial of labor

Clint M. Cormier; Mark B. Landon; Yinglei Lai; Catherine Y. Spong; Dwight J. Rouse; Kenneth J. Leveno; Michael W. Varner; Hyagriv N. Simhan; Ronald J. Wapner; Yoram Sorokin; Menachem Miodovnik; Marshall Carpenter; Alan M. Peaceman; Mary J. O'Sullivan; Baha M. Sibai; Oded Langer; John M. Thorp; Brian M. Mercer

doi:10.1097/AOG.0b013e3181c534ca

White's classification of maternal diabetes and vaginal birth after cesarean delivery success in women undergoing a trial of labor

Clint M. Cormier, Mark B. Landon, Yinglei Lai, Catherine Y. Spong, Dwight J. Rouse, Kenneth J. Leveno, Michael W. Varner, Hyagriv N. Simhan, Ronald J. Wapner, Yoram Sorokin, Menachem Miodovnik, Marshall Carpenter, Alan M. Peaceman, Mary J. O'Sullivan, Baha M. Sibai, Oded Langer, John M. Thorp, Brian M. Mercer

Research output: Contribution to journal › Article › peer-review

21 Scopus citations

Abstract

Objective: To estimate the rate of vaginal birth after cesarean delivery (VBAC) success in diabetic women based on White's Classification. Methods: This is a secondary analysis of an observational study conducted at 19 medical centers of women attempting VBAC. Diabetic women with singleton gestations, one prior cesarean delivery, and cephalic presentation who underwent a trial of labor were included. Vaginal birth after cesarean delivery success rates and maternal and neonatal complications were compared based on White's Classification. Results: Of 11,856 women who underwent trial of labor, 624 met all study criteria (class A1, 356; A2, 169; B, 70; C, 21; D/R/F, 8). Vaginal birth after cesarean delivery success in each group was: A1, 68.5% (95% confidence interval [CI] 63.4-73.3%); A2, 55% (95% CI 47.2-62.7%); B, 70% (95% CI 57.9-80.4%); C, 47.6% (95% CI 25.7-70.2%); and D/F/R, 12.5% (95% CI 0.3-52.7%). Maternal and neonatal complications were rare and not found to be different among groups. CONCLUSION: Our study provides estimates for VBAC success based on White's classification and indicates a relatively low rate of perinatal complications after VBAC attempt for diabetic women.

Original language	English (US)
Pages (from-to)	60-64
Number of pages	5
Journal	Obstetrics and gynecology
Volume	115
Issue number	1
DOIs	https://doi.org/10.1097/AOG.0b013e3181c534ca
State	Published - Jan 2010

ASJC Scopus subject areas

Obstetrics and Gynecology

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Cormier, C. M., Landon, M. B., Lai, Y., Spong, C. Y., Rouse, D. J., Leveno, K. J., Varner, M. W., Simhan, H. N., Wapner, R. J., Sorokin, Y., Miodovnik, M., Carpenter, M., Peaceman, A. M., O'Sullivan, M. J., Sibai, B. M., Langer, O., Thorp, J. M., & Mercer, B. M. (2010). White's classification of maternal diabetes and vaginal birth after cesarean delivery success in women undergoing a trial of labor. Obstetrics and gynecology, 115(1), 60-64. https://doi.org/10.1097/AOG.0b013e3181c534ca

Cormier, CM, Landon, MB, Lai, Y, Spong, CY, Rouse, DJ, Leveno, KJ, Varner, MW, Simhan, HN, Wapner, RJ, Sorokin, Y, Miodovnik, M, Carpenter, M, Peaceman, AM, O'Sullivan, MJ, Sibai, BM, Langer, O, Thorp, JM & Mercer, BM 2010, 'White's classification of maternal diabetes and vaginal birth after cesarean delivery success in women undergoing a trial of labor', Obstetrics and gynecology, vol. 115, no. 1, pp. 60-64. https://doi.org/10.1097/AOG.0b013e3181c534ca

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title = "White's classification of maternal diabetes and vaginal birth after cesarean delivery success in women undergoing a trial of labor",

abstract = "Objective: To estimate the rate of vaginal birth after cesarean delivery (VBAC) success in diabetic women based on White's Classification. Methods: This is a secondary analysis of an observational study conducted at 19 medical centers of women attempting VBAC. Diabetic women with singleton gestations, one prior cesarean delivery, and cephalic presentation who underwent a trial of labor were included. Vaginal birth after cesarean delivery success rates and maternal and neonatal complications were compared based on White's Classification. Results: Of 11,856 women who underwent trial of labor, 624 met all study criteria (class A1, 356; A2, 169; B, 70; C, 21; D/R/F, 8). Vaginal birth after cesarean delivery success in each group was: A1, 68.5% (95% confidence interval [CI] 63.4-73.3%); A2, 55% (95% CI 47.2-62.7%); B, 70% (95% CI 57.9-80.4%); C, 47.6% (95% CI 25.7-70.2%); and D/F/R, 12.5% (95% CI 0.3-52.7%). Maternal and neonatal complications were rare and not found to be different among groups. CONCLUSION: Our study provides estimates for VBAC success based on White's classification and indicates a relatively low rate of perinatal complications after VBAC attempt for diabetic women.",

author = "Cormier, {Clint M.} and Landon, {Mark B.} and Yinglei Lai and Spong, {Catherine Y.} and Rouse, {Dwight J.} and Leveno, {Kenneth J.} and Varner, {Michael W.} and Simhan, {Hyagriv N.} and Wapner, {Ronald J.} and Yoram Sorokin and Menachem Miodovnik and Marshall Carpenter and Peaceman, {Alan M.} and O'Sullivan, {Mary J.} and Sibai, {Baha M.} and Oded Langer and Thorp, {John M.} and Mercer, {Brian M.}",

year = "2010",

month = jan,

doi = "10.1097/AOG.0b013e3181c534ca",

language = "English (US)",

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pages = "60--64",

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T1 - White's classification of maternal diabetes and vaginal birth after cesarean delivery success in women undergoing a trial of labor

AU - Cormier, Clint M.

AU - Landon, Mark B.

AU - Lai, Yinglei

AU - Spong, Catherine Y.

AU - Rouse, Dwight J.

AU - Leveno, Kenneth J.

AU - Varner, Michael W.

AU - Simhan, Hyagriv N.

AU - Wapner, Ronald J.

AU - Sorokin, Yoram

AU - Miodovnik, Menachem

AU - Carpenter, Marshall

AU - Peaceman, Alan M.

AU - O'Sullivan, Mary J.

AU - Sibai, Baha M.

AU - Langer, Oded

AU - Thorp, John M.

AU - Mercer, Brian M.

PY - 2010/1

Y1 - 2010/1

N2 - Objective: To estimate the rate of vaginal birth after cesarean delivery (VBAC) success in diabetic women based on White's Classification. Methods: This is a secondary analysis of an observational study conducted at 19 medical centers of women attempting VBAC. Diabetic women with singleton gestations, one prior cesarean delivery, and cephalic presentation who underwent a trial of labor were included. Vaginal birth after cesarean delivery success rates and maternal and neonatal complications were compared based on White's Classification. Results: Of 11,856 women who underwent trial of labor, 624 met all study criteria (class A1, 356; A2, 169; B, 70; C, 21; D/R/F, 8). Vaginal birth after cesarean delivery success in each group was: A1, 68.5% (95% confidence interval [CI] 63.4-73.3%); A2, 55% (95% CI 47.2-62.7%); B, 70% (95% CI 57.9-80.4%); C, 47.6% (95% CI 25.7-70.2%); and D/F/R, 12.5% (95% CI 0.3-52.7%). Maternal and neonatal complications were rare and not found to be different among groups. CONCLUSION: Our study provides estimates for VBAC success based on White's classification and indicates a relatively low rate of perinatal complications after VBAC attempt for diabetic women.

AB - Objective: To estimate the rate of vaginal birth after cesarean delivery (VBAC) success in diabetic women based on White's Classification. Methods: This is a secondary analysis of an observational study conducted at 19 medical centers of women attempting VBAC. Diabetic women with singleton gestations, one prior cesarean delivery, and cephalic presentation who underwent a trial of labor were included. Vaginal birth after cesarean delivery success rates and maternal and neonatal complications were compared based on White's Classification. Results: Of 11,856 women who underwent trial of labor, 624 met all study criteria (class A1, 356; A2, 169; B, 70; C, 21; D/R/F, 8). Vaginal birth after cesarean delivery success in each group was: A1, 68.5% (95% confidence interval [CI] 63.4-73.3%); A2, 55% (95% CI 47.2-62.7%); B, 70% (95% CI 57.9-80.4%); C, 47.6% (95% CI 25.7-70.2%); and D/F/R, 12.5% (95% CI 0.3-52.7%). Maternal and neonatal complications were rare and not found to be different among groups. CONCLUSION: Our study provides estimates for VBAC success based on White's classification and indicates a relatively low rate of perinatal complications after VBAC attempt for diabetic women.

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ER -

White's classification of maternal diabetes and vaginal birth after cesarean delivery success in women undergoing a trial of labor

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