Timing of elective caesarean delivery and neonatal outcomes.
Article Type: Brief article
Subject: Cesarean section (Research)
Cesarean section (Complications and side effects)
Pediatric respiratory diseases (Risk factors)
Pediatric respiratory diseases (Research)
Hypoglycemia (Risk factors)
Hypoglycemia (Research)
Sepsis (Risk factors)
Sepsis (Research)
Infants (Patient outcomes)
Infants (Risk factors)
Infants (Research)
Pub Date: 11/01/2009
Publication: Name: Reproductive Health Matters Publisher: Reproductive Health Matters Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2009 Reproductive Health Matters ISSN: 0968-8080
Issue: Date: Nov, 2009 Source Volume: 17 Source Issue: 34
Topic: Event Code: 310 Science & research
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 225074447
Full Text: Elective repeat caesarean delivery before 39 weeks of gestation is Common. This study investigated associations between elective caesarean delivery at 37-39 weeks of gestation and neonatal outcomes, in a cohort of women with viable singleton pregnancies having a repeat caesarean section at 19 centres in the USA from 1999 to 2002. Risk of neonatal death, respiratory complications, hypoglycaemia, newborn sepsis, and admission to the neonatal intensive care unit were studied. Of 24,077 repeat caesarean deliveries, 13,258 were performed electively, of which 6.3% were delivered at 37 weeks, 29.5% at 38 weeks and 49.1% at 39 weeks of gestation. One neonatal death occurred. As compared with births at 39 weeks, births at 37 weeks and 38 weeks were associated with an increased risk of neonatal death (adjusted odds ratio for births at 37 weeks, 2.1; adjusted odds ratio for births at 38 weeks, 1.5; p for trend<0.001). The rate of adverse events in the newborn was increased by a factor of 1.8 to 4.2 for births at 37 weeks and 1.3 to 2.1 for births at 38 weeks. Because of increased rates of respiratory complications and other adverse neonatal outcomes, elective caesarean section should be discouraged before 39 weeks of gestation. (1)

(1.) Tita ATN, Landon MB, Spong CY, et al. Timing of elective repeat caesarean delivery at term and neonatal outcomes [abstract]. New England Journal of Medicine 2009;360(2):111-20.
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