ObjectivesTo systematically review the risk factors of complete uterine rupture so as to provide evidence for prevention of uterine rupture.MethodsPubMed, EMbase, The Cochrane Library, CBM and CNKI databases were electronically searched to collect case-control studies or cohort studies on the risk of complete uterine rupture from inception to October, 2019. Two reviewers independently screened literature, extracted data and assessed the quality of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 18 studies, involving 2 104 607 cases were included. The results of meta-analysis showed that the risk factors of complete uterine rupture included single-layer suture of uterine incision (OR=1.78, 95%CI 1.15 to 2.78, P=0.01), induction of labor (OR=1.72, 95%CI 1.21 to 2.45, P=0.003) (case-control studies) and (OR=2.66, 95%CI 1.87 to 3.79, P<0.000 01) (cohort studies), induction with prostaglandins (OR=3.23, 95%CI 1.48 to 7.06, P=0.003), induction with oxytocin (OR=3.97, 95%CI 1.65 to 9.59, P=0.002), and augmentation of labor with oxytocin (OR=2.17, 95%CI 1.53 to 3.09, P<0.000 1) (case-control studies) and (OR=2.29, 95%CI 1.24 to 4.23, P=0.008) (cohort studies). There was no significant relationship between birth weight and complete uterine rupture (OR=1.26, 95%CI 0.74 to 2.17, P=0.40).ConclusionsCurrent evidence shows that single layer suture of uterine incision, induction of labor, induction with prostaglandins, induction with oxytocin and augmentation of labor with oxytocin are the risk factors of complete uterine rupture. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.