Cesarean Section at 38 Gestational Weeks for Placenta Previa was Associated With Improved Neonatal Outcomes Without...

The optimal timing of cesarean delivery in women with placenta previa (PP) remains controversial because earlier delivery may reduce maternal risks, whereas later delivery may improve neonatal outcomes. This study aimed to evaluate whether delaying planned cesarean section (CS) until 38 gestational weeks was associated with improved neonatal outcomes without increasing maternal risks in women with PP who remain clinically stable.

This historical control study included women with singleton pregnancies complicated by PP who underwent CS at a single tertiary center between 2015 and 2024. Planned CS was scheduled at 38⁺⁰ to 38⁺⁶ gestational weeks between 2022 and 2024 and at 36⁺⁰ to 37⁺⁶ gestational weeks between 2015 and 2022. Women who underwent emergency CS or developed obstetric complications, including antepartum hemorrhage or threatened preterm labor, were excluded from the primary analysis. Women who underwent planned CS at the scheduled gestational weeks were assigned to Group A (38-week group) and Group B (36-37-week group). Maternal and neonatal outcomes were compared between the groups.

Of the 204 eligible women, 29 were included in Group A and 81 in Group B. Maternal outcomes, including blood loss, operation time, and rates of severe complications, were comparable between the groups. In contrast, neonatal outcomes were improved in Group A, with higher birthweight and lower rates of neonatal hospitalization and hypoglycemia. Most obstetric complications occurred before 36 gestational weeks in both periods.

Delaying planned CS until 38 gestational weeks in clinically stable women with PP was associated with improved neonatal outcomes without an apparent increase in maternal risks or emergency CS. These findings support further investigation of the optimal timing of delivery in women with PP.