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Neonatal respiratory morbidity after elective cesarean section.
Ariel Many1, Limor Helpman, Yael Vilnai
1Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. many@post.tau.ac.il
Summary
Neonates born via elective cesarean delivery (ECD) show higher rates of respiratory morbidity compared to vaginal births. Early ultrasound confirmation of gestational age (GA) suggests factors beyond iatrogenic prematurity contribute to this risk.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Perinatal Research
Background:
- Elective Cesarean Delivery (ECD) is increasingly common.
- Accurate gestational age (GA) assessment is crucial for perinatal outcomes.
- Respiratory morbidity in neonates remains a significant concern.
Purpose of the Study:
- To investigate the incidence of respiratory morbidity in neonates born via elective cesarean delivery (ECD) at term.
- To determine if early, confirmed gestational age (GA) influences this risk.
- To compare neonatal respiratory outcomes between ECD and spontaneous vaginal delivery.
Main Methods:
- Study included women with singleton pregnancies undergoing ECD at term (>38 1/7 weeks), with GA confirmed by first-trimester ultrasound.
- Excluded were multiple gestations, intrapartum cesarean sections, and induced deliveries.
- A control group of women with spontaneous term vaginal deliveries was randomly selected.
Main Results:
- The ECD group (277 neonates) experienced significantly higher rates of neonatal intensive care unit (NICU) admission for respiratory disorders compared to the spontaneous vaginal delivery group (311 neonates) (5 vs. 0, p < 0.02).
- Multivariate analysis did not identify other independent risk factors for respiratory complications.
- Exclusion of diabetic women did not alter the observed association.
Conclusions:
- Neonates delivered by ECD exhibit a higher rate of respiratory morbidity than those delivered vaginally.
- First-trimester ultrasound confirmation of gestational age (GA) suggests that iatrogenic prematurity is unlikely to be the sole cause of this increased morbidity.