| Neonatal outcomes after elective cesarean delivery. | |
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MedLine Citation:
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PMID: 19461417 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To examine the outcomes of neonates born by elective repeat cesarean delivery compared with vaginal birth after cesarean (VBAC) in women with one prior cesarean delivery and to evaluate the cost differences between elective repeat cesarean and VBAC. METHODS: We conducted a retrospective cohort study of 672 women with one prior cesarean delivery and a singleton pregnancy at or after 37 weeks of gestation. Women were grouped according to their intention to have an elective repeat cesarean or a VBAC (successful or failed). The primary outcome was neonatal intensive care unit (NICU) admission and measures of respiratory morbidity. RESULTS: Neonates born by cesarean delivery had higher NICU admission rates compared with the VBAC group (9.3% compared with 4.9%, P=.025) and higher rates of oxygen supplementation for delivery room resuscitation (41.5% compared with 23.2%, P<.01) and after NICU admission (5.8% compared with 2.4%, P<.028). Neonates born by VBAC required the least delivery room resuscitation with oxygen, whereas neonates delivered after failed VBAC required the greatest degree of delivery room resuscitation. The costs of elective repeat cesarean were significantly greater than VBAC. However, failed VBAC accounted for the most expensive total birth experience (delivery and NICU use). CONCLUSION: In comparison with vaginal birth after cesarean, neonates born after elective repeat cesarean delivery have significantly higher rates of respiratory morbidity and NICU-admission and longer length of hospital stay. LEVEL OF EVIDENCE: II. |
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Authors:
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Beena D Kamath; James K Todd; Judith E Glazner; Dennis Lezotte; Anne M Lynch |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 113 ISSN: 0029-7844 ISO Abbreviation: Obstet Gynecol Publication Date: 2009 Jun |
Date Detail:
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Created Date: 2009-05-22 Completed Date: 2009-06-30 Revised Date: 2013-04-11 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 1231-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Denver, Colorado 80045, USA. Beena.Kamath@ucdenver.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cesarean Section* Cesarean Section, Repeat Cohort Studies Female Humans Infant, Newborn / physiology* Intensive Care, Neonatal Length of Stay Pregnancy Pregnancy Outcome Resuscitation Retrospective Studies Surgical Procedures, Elective |
| Grant Support | |
ID/Acronym/Agency:
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L40 HD059452/HD/NICHD NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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