Document Detail


Neonatal outcomes after elective cesarean delivery.
MedLine Citation:
PMID:  19461417     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Beena D Kamath; James K Todd; Judith E Glazner; Dennis Lezotte; Anne M Lynch
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  113     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-22     Completed Date:  2009-06-30     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1231-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Denver, Colorado 80045, USA. Beena.Kamath@ucdenver.edu
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MeSH Terms
Descriptor/Qualifier:
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:
L40 HD059452/HD/NICHD NIH HHS
Comments/Corrections

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