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Abstract

Background: Preterm labor remains a leading cause of neonatal morbidity and mortality worldwide. Various maternal and obstetric factors have been implicated, but the role of the number of previous cesarean sections (C-sections) in contributing to preterm birth risk remains insufficiently explored.
Objective: To determine whether having more than two previous cesarean sections increases the risk of preterm labor in pregnant women.
Methods: A case-control study was conducted at the Department of Gynecology and Obstetrics, Khyber Teaching Hospital Peshawar, over a period of six months. A total of 176 women were enrolled, with 88 in the preterm labor group (cases) and 88 in the term delivery group (controls). Data on demographics and number of previous C-sections were collected through a structured proforma. Statistical analysis was performed using SPSS version 22.0, employing chi-square tests and odds ratio calculations to determine associations.
Results: The mean age of participants was comparable between groups. A significantly higher proportion of women in the case group (45.5%) had more than two prior cesarean sections compared to the control group (18.2%). Statistical analysis revealed a significant association between more than two prior cesarean sections and preterm labor (p < 0.05), with an odds ratio of 4.17 (95% CI: 2.08–8.36).
Conclusion: An increased number of previous cesarean sections is significantly associated with a higher risk of preterm labor. These findings support the need for judicious use of cesarean delivery and comprehensive patient counseling on long-term reproductive implications.