Daragh Finn1, Sinéad M O'Neill2,3, Aedin Collins1, Ali S Khashan3,4, Keelin O'Donoghue4, Eugene Dempsey1. 1. a Department of Paediatrics and Child Health, Neonatal Intensive Care Unit , University College Cork , Cork , Ireland . 2. b Department of Obstetrics and Gynecology , National Perinatal Epidemiology Centre, Anu Research Centre, Cork University Maternity Hospital , Wilton , Cork , Ireland . 3. c The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork , Cork , Ireland , and. 4. d Department of Obstetrics and Gynaecology , University College Cork , Cork , Ireland.
Abstract
OBJECTIVE: To assess neonatal outcomes following elective caesarean delivery (CD) at term (≥37 + 0 weeks gestation). METHODS: A retrospective cohort study was conducted in a single Irish maternity hospital. Elective CDs at term between August 2008 and July 2012 were reviewed. Outcome measures were admission to the neonatal intensive care unit (NICU), length of stay, respiratory complications, hypoglycaemia, jaundice, newborn sepsis and medical interventions. RESULTS: A total of 4242 women had an elective CD at term, accounting for approximately 15% of all term deliveries. Admission rate to the NICU at 37 weeks gestation was 21.8% versus 10% at 39 weeks (p for trend <0.0001). Similar trends of decreasing risk with later gestational age were noted for the other outcomes. An increased odds of admission to the NICU at 37 weeks [adjusted odds ratio (OR) 2.48 (95% CI 1.28, 4.79)] and at 38 weeks [OR 1.34, 95% CI 1.02, 1.77] compared to the reference of 39 weeks gestation was found. CONCLUSIONS: This study supports evidence that, with regard to neonatal outcome, 39 weeks gestational age is the optimal delivery time. Heightened awareness of the increased risk of neonatal morbidity, when delivery is performed electively before 39 weeks, is warranted among healthcare workers.
OBJECTIVE: To assess neonatal outcomes following elective caesarean delivery (CD) at term (≥37 + 0 weeks gestation). METHODS: A retrospective cohort study was conducted in a single Irish maternity hospital. Elective CDs at term between August 2008 and July 2012 were reviewed. Outcome measures were admission to the neonatal intensive care unit (NICU), length of stay, respiratory complications, hypoglycaemia, jaundice, newborn sepsis and medical interventions. RESULTS: A total of 4242 women had an elective CD at term, accounting for approximately 15% of all term deliveries. Admission rate to the NICU at 37 weeks gestation was 21.8% versus 10% at 39 weeks (p for trend <0.0001). Similar trends of decreasing risk with later gestational age were noted for the other outcomes. An increased odds of admission to the NICU at 37 weeks [adjusted odds ratio (OR) 2.48 (95% CI 1.28, 4.79)] and at 38 weeks [OR 1.34, 95% CI 1.02, 1.77] compared to the reference of 39 weeks gestation was found. CONCLUSIONS: This study supports evidence that, with regard to neonatal outcome, 39 weeks gestational age is the optimal delivery time. Heightened awareness of the increased risk of neonatal morbidity, when delivery is performed electively before 39 weeks, is warranted among healthcare workers.
Authors: Barbara Prediger; Tim Mathes; Stephanie Polus; Angelina Glatt; Stefanie Bühn; Sven Schiermeier; Edmund A M Neugebauer; Dawid Pieper Journal: BMC Pregnancy Childbirth Date: 2020-07-08 Impact factor: 3.007