Neonatal outcome following elective cesarean section beyond 37 weeks of gestation: a 7-year retrospective analysis of a national registry

Am J Obstet Gynecol. 2010 Mar;202(3):250.e1-8. doi: 10.1016/j.ajog.2010.01.052.

Abstract

Objective: We sought to evaluate number and timing of elective cesarean sections at term and to assess perinatal outcome associated with this timing.

Study design: We conducted a recent retrospective cohort study including all elective cesarean sections of singleton pregnancies at term (n = 20,973) with neonatal follow-up. Primary outcome was defined as a composite of neonatal mortality and morbidity.

Results: More than half of the neonates were born at <39 weeks of gestation, and they were at significantly higher risk for the composite primary outcome than neonates born thereafter. The absolute risks were 20.6% and 12.5% for birth at <38 and 39 weeks, respectively, as compared to 9.5% for neonates born > or = 39 weeks. The corresponding adjusted odds ratios (95% confidence interval) were 2.4 (2.1-2.8) and 1.4 (1.2-1.5), respectively.

Conclusion: More than 50% of the elective cesarean sections are applied at <39 weeks, thus jeopardizing neonatal outcome.

MeSH terms

  • Adult
  • Age Factors
  • Apgar Score
  • Birth Weight
  • Cesarean Section / statistics & numerical data*
  • Cohort Studies
  • Continental Population Groups
  • Female
  • Gestational Age*
  • Humans
  • Hypoglycemia / epidemiology
  • Infant Mortality*
  • Infant, Newborn
  • Infant, Newborn, Diseases / epidemiology*
  • Intensive Care Units, Neonatal
  • Intracranial Hemorrhages / epidemiology
  • Netherlands / epidemiology
  • Outcome Assessment, Health Care*
  • Parity
  • Patient Admission / statistics & numerical data
  • Pregnancy
  • Pulmonary Edema / epidemiology
  • Registries
  • Respiratory Distress Syndrome, Newborn / epidemiology
  • Resuscitation / methods
  • Resuscitation / statistics & numerical data
  • Retrospective Studies
  • Seizures / epidemiology
  • Sepsis / epidemiology