Related Experiment Video
Updated: Jun 3, 2026
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Trends in cesarean delivery at preterm gestation and association with perinatal mortality
Cande V Ananth1, Anthony M Vintzileos
1Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, 08901-1977, USA. cande.ananth@umdnj.edu
Objective:
We sought to examine the extent to which a temporal increase in preterm cesarean delivery is associated with gestational age-specific changes in perinatal survival in preterm gestations.
Study Design:
We utilized data on singleton births in the United States (1990 through 2004) delivered between 24-36 weeks' gestation. Associations between changes in cesarean delivery at preterm gestations and trends in the risk of preterm stillbirth, and neonatal and perinatal mortality were estimated before and after adjustments for a variety of potential confounders.
Results:
From 1990 through 2004, cesarean delivery rates increased by 50.6%, 40.7%, and 35.8% at 24-27, 28-33, and 34-36 weeks, respectively. The largest incremental effect of cesarean was associated with a reduction in stillbirths by 5.8%, 14.2%, and 23.1% at 24-27, 28-33, and 34-36 weeks, respectively, leading to an 11.4%, 4.9%, and 0.6% reduction in perinatal deaths at 24-27, 28-33, and 34-36 weeks, respectively.
Conclusion:
Increasing rates of preterm cesarean were associated with improved perinatal survival. This association was evident largely because of dramatic incremental declines in stillbirths.
