Morbidities in Neonates Delivered Electively at Early Term

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Perinatal Epidemiology

Background:

• Elective cesarean deliveries are increasingly common.
• Optimal timing for elective term deliveries remains a subject of study.
• Early term deliveries may carry risks for neonates.

Purpose of the Study:

• To determine the incidence of elective cesarean deliveries at term (37-40 weeks gestation).
• To analyze neonatal outcomes in relation to gestational age at elective delivery.
• To correlate neonatal morbidity with different gestational ages for elective cesarean births.

Main Methods:

• Retrospective analysis of elective cesarean deliveries between January 2012 and April 2013.
• Comparison of neonatal outcomes, including NICU admissions and respiratory distress, across gestational ages (37-40 weeks).
• Statistical analysis of morbidity rates, ventilator/CPAP usage, and hospitalization duration based on delivery timing.

Main Results:

• Incidences of elective delivery were 10.6% at 37, 29.7% at 38, 28% at 39, and 31.5% at 40 weeks.
• Neonates born at 37 weeks had significantly higher rates of NICU admission (RR 3.94) and respiratory distress (RR 5.255) compared to those born at 39 weeks.
• Increased respiratory morbidity, NICU admissions, and longer hospital stays were observed in neonates delivered at <39 weeks gestation.

Conclusions:

• Over one-third of term infants are electively delivered before 39 weeks, despite recommendations.
• Early term elective deliveries (<39 weeks) are associated with substantially increased neonatal respiratory morbidity and NICU admissions.
• Restricting non-emergent elective deliveries to 39 weeks gestation is crucial for minimizing neonatal complications.