Eyal Sheiner
Ben Gurion University of the Negev, Faculty of Health Sience, Faculty Member
This study aims to examine whether renal function during pregnancy can serve as a surrogate marker for the risk of developing atherosclerotic-related morbidity. a case-control study, including women who gave birth at a tertiary referral... more
This study aims to examine whether renal function during pregnancy can serve as a surrogate marker for the risk of developing atherosclerotic-related morbidity. a case-control study, including women who gave birth at a tertiary referral medical center during 2000-2012. This population was divided into cases of women who were subsequently hospitalized for atherosclerotic morbidity during the study period and age-matched controls. From the study population, we retrieved two groups: the creatinine (Cr) group: women who had at least one Cr measurement (4945 women) and the urea group: women who had at least one urea measurement (4932 women) during their pregnancies. In the Cr and urea group, there were 572 and 571 cases and 4373 and 4361 controls respectively. The mean follow-up period in the Cr and urea group was 61.7±37.0 and 57.3±36.0 months respectively. Cox proportional hazards models (controlling for confounders: gestational hypertension, gestational diabetes, obesity, maternal age, creatinine level (for urea), and gestational week) were used to estimate the adjusted hazard ratios (HR) for hospitalizations. A significant association was documented between renal function during pregnancy and long-term atherosclerotic morbidity. Multivariate analysis, showed that Cr at pregnancy index of ≥89 μmol/l was associated with a significant increased risk for hospitalization due to cardiovascular (CVS) events (adjusted HR=2.91 CI 1.37-6.19 P=0.005) and urea level ≤7mmol/l was independently associated with reduced prevalence of CVS hospitalization (adjusted HR=0.62 CI 0.57-0.86 P=0.001). Renal function abnormality during pregnancy may reveal occult predisposition to atherosclerotic morbidity years after childbirth.
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To examine the association between potassium level during the first half of pregnancy and the development of gestational diabetes mellitus (GDM) and hypertensive disorders in the second half of the pregnancy. The study population included... more
To examine the association between potassium level during the first half of pregnancy and the development of gestational diabetes mellitus (GDM) and hypertensive disorders in the second half of the pregnancy. The study population included all registered births between the years 2001-2007. The potassium levels during the first half of pregnancy were sorted by the following groups: K < 3.5 mEq/l; K = 3.5-3.99 mEq/l; and K > or = 4 mEq/l. The linear by linear chi(2)-test was used to determine the association between potassium level during the beginning of pregnancy and pregnancy complications. The study population included 8114 deliveries. A significant linear association was documented between potassium level in the first half of the pregnancy and the prevalence of GDM in the second half of the pregnancy: 6.3% in the K < 3.5 mEq/l group, 6.6% in the K = 3.5-3.99 mEq/l group and 8.2% in the K > 4 mEq/l group; (p = 0.008). A statistically significant for lower rates of severe pre-eclampsia was noted between the groups: 0.4% in the K < 3.5 mEq/l group, 0.9% in the K = 3.5-3.99 mEq/l group, 1.3% in the K = 4.0-4.99 mEq/l group and 1.5% in the K > or = 5 mEq/l group, (p = 0.027). Indeed, K > 5 mEq/l was noted as a significant risk factor for both, severe pre-eclampsia and for GDM. Using two multiple logistic regression models controlling for maternal age, potassium level was noted as an independent risk factor for both GDM and severe pre-eclampsia. High potassium levels during the first half of pregnancy are associated with higher risk for the development of GDM and severe pre-eclampsia.
Research Interests: Obstetrics, Medicine, Gestational diabetes, Pregnancy, Population, and 15 moreHumans, Hypertension, Diabetes mellitus, Female, Potassium, Risk factors, Prevalence, Adult, Retrospective Studies, Risk Factors, Gestational Age, Pre Eclampsia, Eclampsia, Paediatrics and reproductive medicine, and gestational diabetes mellitus
To investigate pregnancy outcome of patients with a history of deep vein thrombosis (DVT). A population-based study comparing all pregnancies of patients with and without a history of DVT was conducted. Deliveries occurred during the... more
To investigate pregnancy outcome of patients with a history of deep vein thrombosis (DVT). A population-based study comparing all pregnancies of patients with and without a history of DVT was conducted. Deliveries occurred during the years 1988-2007 at a tertiary Medical Center. Stratified analyses were performed using multivariable logistic regression models and the Mantel-Haenszel technique. During the study there were 212,086 deliveries, of which 122 (0.06%) occurred in patients with a history of DVT. Using a multivariate analysis, with backward elimination, the following conditions were significantly associated with DVT: advanced maternal age (OR, 1.1; 95% CI, 1.02-1.1; p = 0.004), chronic hypertension (OR, 2.9; 95% CI, 1.4-6.0; p = 0.005) and previous caesarean delivery (OR, 2.8; 95% CI, 1.9-4.1; p < 0.001). Patients with a history of DVT were more likely to have caesarean deliveries (OR, 2.6; 95% CI, 1.8-3.8; p < 0.001) than non-DVT patients. After controlling for possible confounders, such as maternal age, hypertensive disorders, pregestational diabetes and multiple gestations, by using another multivariate analysis with preterm delivery (<37 weeks' gestation) as the outcome variable, DVT was found to be an independent risk factor for preterm birth (OR, 1.8; 95% CI, 1.1-2.9; p = 0.033). This association remained significant after controlling for labor induction, using the Mantel-Haenszel technique (OR, 1.8; 95% CI, 1.1-3.0; p = 0.011). No significant differences were noted between the groups regarding perinatal outcomes such as low Apgar scores, congenital malformations or perinatal mortality. A history of DVT is an independent risk factor for spontaneous preterm delivery. Nevertheless, in our population it is not associated with adverse perinatal outcome.
Research Interests: Obstetrics, Adolescent, Medicine, Logistic Regression, Israel, and 14 moreMultivariate Analysis, Pregnancy, Humans, Female, Young Adult, Maternal, Adult, Thrombosis, Logistic Models, Pregnancy Outcome, Deep Venous Thrombosis, Venous Thrombosis, Pregnancy complications, and Paediatrics and reproductive medicine
To determine the relationship between maternal serum ferritin concentrations in the second trimester and the risk of preterm delivery (PTD). A prospective observational study was conducted. Fifty consecutive women with singleton... more
To determine the relationship between maternal serum ferritin concentrations in the second trimester and the risk of preterm delivery (PTD). A prospective observational study was conducted. Fifty consecutive women with singleton pregnancies, who were admitted to the Maternal Fetal Medicine Unit due to preterm labor in the second trimester, were included. Maternal serum samples for determination of ferritin concentrations were obtained. Multiple logistic regression analysis was performed to control for confounders. Out of fifty patients enrolled in the study, 38% (19/50) delivered prematurely. Eight women (16%) had maternal serum ferritin concentrations above 30 ng/ml in the second trimester. Among them, 75% (n = 6) subsequently presented with preterm delivery (odds ratio (OR) = 6.7 with 95% confidence interval (CI) 1.1-56.2, p = 0.04). Only two patients with increased maternal ferritin concentrations delivered at term. However, 13 patients with second trimester ferritin concentrations below 30 ng/ml had preterm delivery. No significant differences in mean maternal ferritin concentrations were found between patients who delivered preterm and those that delivered at term, 31.9 +/- 50.6 vs. 13.6 +/- 15.2, respectively (p = 0.064). Using a multivariable analysis, controlling for anemia, leucocytosis and maternal age, increased serum ferritin concentrations were found to be an independent risk factor for PTD (OR = 8.6; 95% CI 1.4-52.5; p < 0.019). No significant correlation was found between serum ferritin concentrations and gestational age at birth (Pearson correlation coefficient r = -0.093; p = 0.522). Maternal ferritin concentrations above 30 ng/ml in the second trimester can serve as a marker for preterm delivery. However, since no correlation was found between serum ferritin concentrations and gestational age at birth, the routine use of serum ferritin as a marker for preterm delivery warrants further investigation.
Research Interests: Obstetrics, Medicine, Logistic Regression, Multivariate Analysis, Prospective studies, and 15 morePregnancy, Humans, Female, Maternal, Ferritin, Adult, Odds ratio, Biological markers, Risk Factors, Logistic Models, Preterm Labor, Confidence Interval, confounding, Paediatrics and reproductive medicine, and Obstetric Labor Premature
... Hum. Reprod.16,961965 (2001). 13, Raziel A, Kornberg Y, Friedler S, Schachter M, Sela BA, Ron-El R. Hypercoagulable thrombophilic defects and hyperhomocysteinemia in patients with recurrent pregnancy loss. Am. J. Reprod.... more
... Hum. Reprod.16,961965 (2001). 13, Raziel A, Kornberg Y, Friedler S, Schachter M, Sela BA, Ron-El R. Hypercoagulable thrombophilic defects and hyperhomocysteinemia in patients with recurrent pregnancy loss. Am. J. Reprod. Immunol.46,6571 (2001). ...
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Research Interests: Obstetrics, Medicine, Abortion, Pregnancy, Humans, and 14 moreFemale, Maternal Age, Analysis of Variance, Pregnancy Complication, Cesarean Section, PROM, Logistic Models, Pregnancy Outcome, Intrauterine Growth Restriction, Pregnancy complications, Placenta previa, Paediatrics and reproductive medicine, Abruptio placentae, and Fetal Growth Retardation
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The study was aimed to compare pregnancies complicated with shoulder dystocia, of patients with and without diabetes mellitus. A comparison of all singleton, vertex, term deliveries between the years 1988-1999, complicated with shoulder... more
The study was aimed to compare pregnancies complicated with shoulder dystocia, of patients with and without diabetes mellitus. A comparison of all singleton, vertex, term deliveries between the years 1988-1999, complicated with shoulder dystocia with and without diabetes mellitus was performed. Statistical analysis was done using receiver operating characteristic curve analysis. Using a receiver operating characteristic curve analysis, the area under the curve for birth weight was 0.92 (95% CI 0.90-0.93). However, for birth weight of 4,000 g the sensitivity was only 56% with specificity of 95%. While comparing shoulder dystocia between patients with (n=38) and without diabetes mellitus (n=207), neonates of the diabetic patients were significantly heavier (mean birth weight 4,244.2+/-515.1 vs. 4,051.6+/-389.5; P=0.008) and had higher rate of Apgar scores lower than 7 at 1 min (50.0% vs. 25.9%; P=0.030), but not at 5 min (2.6% vs. 2.0%; P=0.083) when compared to the non-diabetic group. No significant differences were noted regarding perinatal mortality between the groups (0% vs. 4.3%; P=0.362). The newborn of the diabetic mother complicated with shoulder dystocia does not appear to be at an increased risk for perinatal morbidity compared with the newborn of the non-diabetic mother.
Research Interests: Obstetrics, Medicine, Birth Weight, Pregnancy, Humans, and 15 moreDiabetes mellitus, Female, Newborn Infant, Adult, Diabetes complications, Retrospective Studies, Pregnancy Complication, Risk Factors, Perinatal mortality, Area Under the Curve, Receiver Operating Characteristic, Area Under Curve, Apgar Score, Dystocia, and Paediatrics and reproductive medicine
The purpose of this study was to examine whether women with inherited thrombophilia have an increased risk of developing pregnancy complications. All singleton pregnancies with known inherited thrombophilia were compared to those without... more
The purpose of this study was to examine whether women with inherited thrombophilia have an increased risk of developing pregnancy complications. All singleton pregnancies with known inherited thrombophilia were compared to those without inherited thrombophilia for deliveries during the years 2000-2002 in a tertiary medical center. Data regarding inherited thrombophilia (International Classification of Disease 9th revision, Clinical Modification code 286.3) were available from the perinatal database in our center. Women lacking prenatal care were excluded from the analysis. Stratified analysis, using a multiple logistic regression model, was performed to control for confounders. Out of 32,763 singleton deliveries that occurred during the study period, 0.2% (n=57) of the women were diagnosed with inherited thrombophilia. Using a multivariate analysis, with backward elimination, the following conditions were significantly associated with inherited thrombophilia: previous fetal losses [odds ratio (OR)=5.5; 95% confidence interval (CI) 2.9-10.3; P<0.001], recurrent abortions (OR=9.5; 95% CI 5.5-16.3; P<0.001), fertility treatments (OR=3.7; 95% CI 1.3-10.6; P=0.014), and intrauterine growth restriction (OR=7.2; 95% CI 3.4-15; P<0.001). Perinatal mortality was significantly higher in women with inherited thrombophilia than in those without known thrombophilia 5.3% (3/57) versus 0.6% (477/32,763) P=0.017. However, inherited thrombophilia was not found to be an independent risk factor for perinatal mortality (OR=3.05; 95% CI 0.90-10.3; P<0.073) in a multivariate analysis with perinatal mortality as the outcome variable, controlling for recurrent abortions, IUGR, and gestational age. Inherited thrombophilia, associated with previous fetal losses, recurrent abortions, fertility treatments, and intrauterine growth restriction, was not an independent risk factor for perinatal mortality.
Research Interests: Obstetrics, Medicine, Israel, Multivariate Analysis, Pregnancy, and 15 moreHumans, Female, Risk factors, International Classification of Diseases, Odds ratio, Pregnancy Complication, Risk Factors, Perinatal mortality, Logistic Regression Model, Prenatal Care, Pregnancy Outcome, Intrauterine Growth Restriction, Confidence Interval, thrombophilia, and Paediatrics and reproductive medicine
Research Interests: Obstetrics, Medicine, Israel, Colonization, Pregnancy, and 15 moreHumans, Female, Male, Newborn Infant, Adult, Pregnancy Complication, Chorioamnionitis, Perinatal mortality, Perinatal Outcome, Prenatal Care, Pregnancy Outcome, Cohort Studies, Premature Rupture of Membranes, Paediatrics and reproductive medicine, and Group B Streptococci
Research Interests: Medicine, Pregnancy, Humans, Female, Male, and 13 moreAnesthesia, Patient Satisfaction, Visual Analogue Scale, Newborn Infant, Adult, Thoracic epidural analgesia, Pain Measurement, Epidural Analgesia, Anesthesia Intravenous, Meperidine, Pethidine, Visual Analog Scale, and Paediatrics and reproductive medicine
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Research Interests: Obstetrics, Medicine, Multivariate Analysis, Fetal development, Humans, and 15 moreFemale, Confidence intervals, American, Clinical Sciences, Adult, Maternal Age, Odds ratio, Fetus, Gestational Age, Gestation, Congenital abnormalities, Confidence Interval, Cohort Studies, confounding, and crown rump length
The purpose of this study was to evaluate perinatal outcomes of infants who had pathologic fetal heart rate tracings during the first stage of labor, in comparison with pregnancies with normal tracings. The perinatal outcomes of 301... more
The purpose of this study was to evaluate perinatal outcomes of infants who had pathologic fetal heart rate tracings during the first stage of labor, in comparison with pregnancies with normal tracings. The perinatal outcomes of 301 infants born at 37 to 42 weeks of gestation with pathologic fetal heart rate patterns during the first stage of labor were compared with 300 infants with normal fetal heart rate tracing patterns. The data were collected prospectively. Tracings were interpreted with the use of the National Institute of Child Health and Human Development fetal heart rate monitor guidelines. Hydramnios (odds ratio, 7.68; 95% CI, 1.75%-33.63%), oligohydramnios (odds ratio, 2.74; 95% CI, 1.01%-7.39%), and the presence of meconium-stained amniotic fluid (odds ratio, 1.91; 95% CI, 1.03%-3.3%) were independent factors that were associated with pathologic fetal heart rate monitoring during the first stage of labor in a multivariable analysis. The occurrences of umbilical arterial pH of <7.20, a 1-minute Apgar score of <7, a base deficit of 12 mmol/L or higher, and operative deliveries were significantly higher in the study group as compared with subjects with normal fetal heart rate monitoring. Late decelerations and severe variable decelerations (<70 bpm) during the first stage of labor were independent risk factors (odds ratio, 17.5; 95% CI, 1.61%-185.7% and odds ratio, 3.9; 95% CI, 1.36%-11.7%, respectively) that were associated with fetal acidosis (determined by both pH of <7.2 and a base deficit of 12 mmol/L or higher) in a multiple logistic model, controlled for hydramnios, oligohydramnios, meconium-stained amniotic fluid, augmentation by oxytocin, nulliparity, duration of first stage of labor, and birth weight. The operative delivery rate was higher among patients with abnormal first-stage fetal heart rate patterns. Late decelerations and severe variable decelerations were significant factors associated with fetal acidosis.
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Research Interests: Obstetrics, Bariatric Surgery, Obesity, Risk assessment, Medicine, and 14 moreBirth Weight, Gestational diabetes, Pregnancy, Humans, Preeclampsia, Female, Body Mass Index, Public health systems and services research, Cesarean Section, Risk Assessment, Gestational Age, Congenital abnormalities, Pre Eclampsia, and Paediatrics and reproductive medicine
Research Interests: Obstetrics, Epidemiology, Medicine, Pregnancy, Humans, and 12 morePreeclampsia, Female, Endometriosis, Cesarean Section, Female Infertility, Postpartum Hemorrhage, Pregnancy Outcome, Premature Birth, Pre Eclampsia, Pregnancy complications, Medical and Health Sciences, and Paediatrics and reproductive medicine
Research Interests: Obstetrics, Medicine, Pregnancy, Population, Humans, and 15 moreFemale, Clinical Sciences, Adult, Endometriosis, Retrospective Studies, Cesarean Section, Laparoscopy, Logistic Models, Pregnancy Outcome, Case Control Studies, Laparotomy, confounding, Pregnancy complications, Medical and Health Sciences, and Paediatrics and reproductive medicine
To determine whether perineal massage during the second stage of labor using oil enriched with vitamins, increases the chances of delivering with an intact perineum as compared to perineal massage using pure liquid wax. A prospective,... more
To determine whether perineal massage during the second stage of labor using oil enriched with vitamins, increases the chances of delivering with an intact perineum as compared to perineal massage using pure liquid wax. A prospective, randomized, double-blind study was conducted. Women were assigned to liquid wax (jojoba oil) versus purified formula of almond and olive oil, enriched with vitamin B1, B2, B6, E and fatty acids. The caregivers used the oils during the second stage of labor. A total of 164 women undergoing vaginal delivery were recruited. No significant differences regarding perineal lacerations, number of sutures and length of suturing were noted between the two groups. Likewise, while analyzing separately nulliparous and multiparous women, no significant differences were noted. Controlling for birth weight >4000 g, using the Mantel-Haenszel technique, no association was noted between perineal lacerations and the type of oil used (weighted OR = 0.9, 95% CI 0.3-2.4; p = 0.818). The type of the oil used during the second stage of labor for prevention of perineal tears has no effect on the integrity of the perineum. Accordingly, it seems that there is no perfect oil.
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Illegal drug abuse causes significant health problems with consequences to the mother and the neonate, and an economic burden to the health system. The present study aimed to investigate pregnancy and perinatal outcome in women using... more
Illegal drug abuse causes significant health problems with consequences to the mother and the neonate, and an economic burden to the health system. The present study aimed to investigate pregnancy and perinatal outcome in women using illegal drugs prior to and during pregnancy. A retrospective cohort study comparing pregnancy and neonatal outcomes of drug addicted women to the outcomes of other Jewish women. The study population includes all women who gave birth between the years 1989-2008 at the Soroka University Medical Center. From a total of 106,000 deliveries, 119 women were known to be drug addicted. No significant differences were found between the groups regarding maternal age and origin, but more women in the addicted group smoked, and tacked prenatal care. More women in the addicted group had obstetrics complications such as: recurrent abortions, placenta previa, pLacental abruption and preterm labor. Illegal drug abuse was significantly associated with adverse perinatal o...
Research Interests: Obstetrics, Adolescent, Medicine, Israel, Pregnancy, and 15 morePopulation, Humans, Low Birth Weight, Female, Pubmed, Adult, Retrospective Studies, Risk Factors, Cost of Illness, Pregnancy Outcome, Cohort Studies, placental abruption, Pregnancy complications, Placenta previa, and Obstetric Labor Premature
The aim of the study was to examine the stimulatory effect of the inflammatory agent lipopolysaccharide (LPS) on the capacity of human term placenta to secrete interleukin (IL)-15 and IL-18. Isolated placental cotyledons from normal human... more
The aim of the study was to examine the stimulatory effect of the inflammatory agent lipopolysaccharide (LPS) on the capacity of human term placenta to secrete interleukin (IL)-15 and IL-18. Isolated placental cotyledons from normal human term deliveries were dually perfused for ten hours with perfusion medium alone (n=5) or with perfusion medium containing LPS (1 microg/kg perfused placental tissue) (n=5). Placental tissue was collected from three different placental compartments (amnion, chorion, and placenta) before and after perfusion. The placental tissues collected were homogenized and examined for IL-15 and IL-18 by ELISA. In addition, formalin-fixed and paraffin-embedded sections from term placentas before perfusion were stained by immunohistochemistry to characterize the cellular origin of placental IL-15 and IL-18. Statistical significance was determined using paired/unpaired t-test. p<0.05 was considered significant. Our results show that IL-15 and IL-18 are produced m...
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To investigate pregnancy outcome of patients with beta-thalassemia minor. A population-based study comparing all pregnancies of women with and without beta-thalassemia minor was conducted. Deliveries occurred during the years 1988-2002 at... more
To investigate pregnancy outcome of patients with beta-thalassemia minor. A population-based study comparing all pregnancies of women with and without beta-thalassemia minor was conducted. Deliveries occurred during the years 1988-2002 at Soroka University Medical Center. A multivariate logistic regression model, with backward elimination, was constructed to find independent risk factors associated with maternal beta-thalassemia minor. During the study period there were 159,195 deliveries, of which 261 (0.2%) occurred in patients with beta-thalassemia minor. The following conditions were significantly associated with beta-thalassemia minor: oligohydramnios (odds ratio [OR] 2.1; 95% confidence interval [CI] 1.2%, 3.7%), intrauterine growth restriction (IUGR; OR 2.4; 95% CI 1.4%, 4.2%), Jewish ethnicity (OR 1.5; 95% CI 1.2%, 1.9%), and previous cesarean delivery (OR 1.4; 95% CI 1.1%, 2.0%). No significant differences were noted between the groups regarding perinatal outcomes such as birth weight, low Apgar scores, congenital malformations, or perinatal mortality. Patients with beta-thalassemia minor were more likely to have cesarean deliveries than were the nonthalassemic parturients (16.9% and 12.2%, respectively; P =.021). However, while controlling for possible confounders such as IUGR, oligohydramnios, and previous cesarean delivery, with another multivariate analysis with cesarean delivery as the outcome variable, beta-thalassemia minor was not found as an independent risk factor for cesarean delivery (OR 1.3; 95% CI 0.9%, 1.9%). The course of pregnancy of patients with thalassemia minor, including perinatal outcomes, is favorable. Because higher rates of IUGR were found, we recommend ultrasound surveillance of fetal weight for early detection of IUGR. II-2
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Research Interests: Medicine, Logistic Regression, Pregnancy, Humans, Female, and 15 moreEuropean, Adult, Odds ratio, Cesarean Section, Logistic Model, Amnion, Logistic Models, Pregnancy Outcome, Confidence Interval, Control Group, Fetal Heart Rate, Premature Rupture of Membranes, Mode of Delivery, High risk, and Paediatrics and reproductive medicine
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Research Interests: Obstetrics, Bariatric Surgery, Medicine, Multivariate Analysis, Gestational diabetes, and 14 morePregnancy, Humans, Diabetes mellitus, Female, American, Adult, Odds ratio, Retrospective Studies, Morbid Obesity, Logistic Models, Pregnancy Outcome, Postoperative Period, Paediatrics and reproductive medicine, and gestational diabetes mellitus
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Abstract Objective: To establish whether failure to progress during labor poses a risk factor for another non-progressive labor (NPL) during the subsequent delivery. Methods: A retrospective cohort study including singleton pregnancies... more
Abstract Objective: To establish whether failure to progress during labor poses a risk factor for another non-progressive labor (NPL) during the subsequent delivery. Methods: A retrospective cohort study including singleton pregnancies that failed to progress during the previous labor and resulted in a cesarean section (CS) was conducted. Parturients were classified into three groups for both previous and subsequent labors: CS due to NPL stage I, stage II and an elective CS as a comparison group. Results: Of 202 462 deliveries, 10 654 women met the inclusion criteria: 3068 women were operated due to NPL stage I and 1218 due to NPL stage II. The comparison group included 6368 women. Using a multivariable logistic regression models, NPL stage I during the previous delivery was found as an independent risk factor for another NPL stage I in the subsequent labor (adjusted odds ratio [OR] = 2.9; 95% confidence interval [CI] = 2.4-3.7; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Similarly, NPL at stage I or II was found to be an independent risk factor for a NPL stage II during the subsequent labor (adjusted OR = 1.4; 95% CI = 1.1-2.1; p = 0.033; adjusted OR = 5.3; 95% CI = 3.7-7.5; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001; respectively). Conclusion: A previous CS due to a NPL is an independent risk factor for another NPL in the subsequent pregnancy and for recurrent cesarean delivery.