TIMING OF ELECTIVE CESAREAN DELIVERY AT TERM AND NEONATAL RESPIRATORY MORBIDITY
Abstract
Aim: To investigate the association between elective cesarean sections and neonatal respiratory morbidity and the importance of timing of elective cesarean sections
Methods: Cohort study with prospectively collected data of all elective Caesarean sections on mothers with a gestational age of 37+0 weeks and more, that were performed in our Hospital from 1 January 2011 to 1 January 2017. Multiple pregnancies, fetuses with congenital anomalies, intrauterine deaths, and emergency Caesarean sections were excluded. Primary outcome measures of neonatal respiratory morbidity included transient tachypnea of newborn, respiratory distress syndrome, persistent pulmonary hypertension of the newborn.
Results: 4290 infants were delivered by elective cesarean section at 37+0 and then after Compared with newborns from vaginal delivery, and emergency cesarean section an increased risk of respiratory morbidity was found for infants delivered by elective cesarean section at 37 +0 weeks’ gestation to 37+6 weeks (odds ratio 4.5 95% confidence interval 3.3 to 6.3), 38+0 weeks’ gestation to 38+6 weeks (2.7 , 1.9 to 3.6 ), and 39+0 weeks’ gestation (2.1, 1.6 to 3.0). Also increasing the incidence of admission to the NICU with decreasing gestational age at term birth below the 39 weeks of gestation
Conclusions: Compared with newborns delivered vaginally or by emergency cesarean sections, those delivered by elective cesarean section around term have an increased risk of respiratory morbidity. The relative risk increased with decreasing gestational age.
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References
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