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DESCRIPTION:JOINT EBOH/CORE SEMINAR SERIES\n\nAzar Mehrabadi\, PhD\n\nAssis
 tant Professor\n	Perinatal Epidemiology Research Unit\n	Departments of Obste
 trics & Gynaecology and Pediatrics\n	Dalhousie University\n\nWHEN: Monday\,
  February 24\, 2025\, from 4 to 5 p.m.\n	WHERE: Hybrid | SPGH\, 2001 ºÃÉ«TVl
  College\, Rm 1140 | Zoom \n	Note: Azar Mehrabadi will be presenting from H
 alifax\n\nAbstract\n\nApproximately 21% of all births worldwide are delive
 red by cesarean\, with rates of 25.7% in Europe and 31.6% in North America
 . Currently\, the most common indication for cesarean delivery in Canada (
 over 30% of cesareans) is a previous cesarean delivery. Increased adoption
  of planned vaginal births following a previous cesarean is a key strategy
  for reducing overall cesarean delivery rates in Canada and globally. Howe
 ver\, controversy remains as to whether the wider adoption of planned vagi
 nal deliveries in this population is safe. A national study of Canada (exc
 luding Quebec) suggested worsening neonatal outcomes over time with a plan
 ned vaginal birth between 2003 and 2014. We conducted a population-based c
 ohort study including 12 681 pregnancies with a previous cesarean delivery
  using the detailed clinically oriented perinatal database in Nova Scotia\
 , Canada. Our study found that among those with a planned vaginal birth ve
 rsus a repeat cesarean\, severe maternal morbidity and severe perinatal-ne
 onatal morbidity increased over time from 2003-08 to 2015-21\, balancing f
 or numerous maternal and clinical characteristics. Oxytocin induction and 
 augmentation increased markedly in this population and could not be ruled 
 out as a factor associated with worsening outcomes. Our study included two
  internal validation studies\, one assessing the outcome of uterine ruptur
 e and one assessing the exposure of planned mode of delivery. In Nova Scot
 ia we found disparities in planned vaginal deliveries and successful vagin
 al deliveries by body mass index (BMI). Our study team has partnered with 
 a provincial health program to implement an evidence-based clinical decisi
 on support tool across Nova Scotia.\n\nLearning Objectives\n\nAt the compl
 etion of this talk\, attendees will be able to:\n\n\n	Understand the histor
 ical and recent evidence informing clinical decision making regarding plan
 ned mode of delivery following a previous cesarean delivery\;\n	Learn to ap
 ply internal validation studies in large\, routinely collected database an
 alyses\;\n	Describe and understand the limitations of study findings on dis
 parities in planned and actual mode of delivery by BMI\;\n	Understand the p
 rocess of implementing an evidence-based clinical decision support tool ad
 dressing planned mode of delivery following a previous cesarean.\n\n\nSpea
 ker Bio\n\nDr. Azar Mehrabadi (PhD) is a perinatal Epidemiologist with exp
 ertise in maternal\, fetal and newborn health research. Dr. Mehrabadi has 
 been Assistant Professor in the Departments of Pediatrics and Obstetrics &
  Gynaecology\, Dalhousie University\, since 2019. She completed a PhD at t
 he University of British Columbia School of Population and Public Health i
 n 2014 and from 2014 to 2019\, she was a postdoctoral fellow at ºÃÉ«TVl Uni
 versity’s Department of Epidemiology\, Biostatistics and Occupational Heal
 th. She is currently conducting research using data from Canada and the Un
 ited Kingdom on obstetrical care and maternal and perinatal-neonatal outco
 mes\, the effects of the social determinants of health on birth outcomes\,
  and trends in medication use in pregnancy and postpartum in Nova Scotia.
 \n
DTSTART:20250224T210000Z
DTEND:20250224T220000Z
SUMMARY:Severe Maternal and Perinatal-Neonatal Morbidity Associated with Pl
 anned Mode of Delivery Following a Previous Cesarean Delivery: Ongoing Sur
 veillance Efforts
URL:/epi-biostat-occh/channels/event/severe-maternal-a
 nd-perinatal-neonatal-morbidity-associated-planned-mode-delivery-following
 -previous-363512
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