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Research Abstract Human Study

Elective cesarean section at term, in an obstetric population without prenatally identified risk factors, remains associated with increased resuscitation risk with related implications for the neonate compared with vaginal delivery.

The influence of timing of elective cesarean section on neonatal resuscitation risk.

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Abstract

OBJECTIVE: Cesarean section has negative effects on the physiologic responses to birth, including the development of lung volumes, pulmonary vascular resistance, and biochemical responses. The objective of this study was to examine the association between the timing of delivery between 37 and 42 wks gestation and neonatal resuscitation risk in elective cesarean section. DESIGN: Observational, cohort study. SETTING: Maternity Department of Padua University, Italy. SUBJECTS: All pregnant women who delivered by elective cesarean section at term during a 3-yr period were identified from a perinatal database and compared retrospectively with pregnant women who delivered vaginally and matched for week of gestation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Comparative neonatal resuscitation risk (odds ratio, OR; confidence interval, CI) was analyzed. During this time, 1,284 (13%) elective cesarean section deliveries occurred at or after 37 wks of gestation. Forty-four (3.4%) newborns delivered by elective cesarean section and 18 (1.4%) newborns vaginally delivered needed positive pressure ventilation resuscitation by laryngeal mask airway or tracheal tube. Positive pressure ventilation resuscitation risk was significantly higher in the infant group delivered by elective cesarean section compared with vaginal delivery (OR, 2.05; CI, 1.25-5.67; p

Affiliation

Department of Pediatrics, Padua University School of Medicine, Via Giustiniani 3, 35128 Padua, Italy. zanardo@pediatria

External References

PubMed ID:
15530194

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