Abdul Razak1, Karthik N Nagesh2, Gayathri Karthik3, Mrinal S Pillai1, Pankaj Kumar Mohanty1. 1. Department of Neonatology, Manipal Hospital, Bangalore, India. 2. Department of Neonatology, Manipal Hospital, Bangalore, India ; Manipal Group of Hospitals, Bangalore, India. 3. Department of Obstetrics and Gynaecology, Manipal Hospital, Bangalore, India.
Abstract
OBJECTIVE: To study the incidence of elective cesarean deliveries at term and to correlate their neonatal outcomes at different gestational ages (37(0/7)-40(6/7)). METHODS: Outcomes including the rate of NICU admissions, usage of ventilator/CPAP, and other morbidities were analysed and compared with the gestational age during the study period from January 2012 to April 2013. RESULTS: The incidences of elective deliveries at 37, 38, 39, and 40 weeks of gestation were 10.6, 29.7, 28, and 31.5 %, respectively. NICU admissions-RR 3.94 (95 % CI 1.92-8.09), respiratory distress-RR 5.255 (95 % CI 1.9-14.4), ventilatory usage, and hospitalization stay (P value < 0.05) were higher in neonates born at 37(0/7-6/7) versus 39(0/7-6/7) weeks (least morbidity group). CONCLUSION: Despite recommendations, more than one-third of term babies are delivered electively at <39 weeks. The fivefold augmented respiratory morbidity and fourfold increased NICU admissions in early term neonates, and the least morbidity in neonates delivered at 39 weeks emphasize the importance of restricting the non-emergent/elective deliveries to 39 weeks of gestation.
OBJECTIVE: To study the incidence of elective cesarean deliveries at term and to correlate their neonatal outcomes at different gestational ages (37(0/7)-40(6/7)). METHODS: Outcomes including the rate of NICU admissions, usage of ventilator/CPAP, and other morbidities were analysed and compared with the gestational age during the study period from January 2012 to April 2013. RESULTS: The incidences of elective deliveries at 37, 38, 39, and 40 weeks of gestation were 10.6, 29.7, 28, and 31.5 %, respectively. NICU admissions-RR 3.94 (95 % CI 1.92-8.09), respiratory distress-RR 5.255 (95 % CI 1.9-14.4), ventilatory usage, and hospitalization stay (P value < 0.05) were higher in neonates born at 37(0/7-6/7) versus 39(0/7-6/7) weeks (least morbidity group). CONCLUSION: Despite recommendations, more than one-third of term babies are delivered electively at <39 weeks. The fivefold augmented respiratory morbidity and fourfold increased NICU admissions in early term neonates, and the least morbidity in neonates delivered at 39 weeks emphasize the importance of restricting the non-emergent/elective deliveries to 39 weeks of gestation.
Entities:
Keywords:
Early term; Elective deliveries; LSCS; Morbidities; Neonate
Authors: Alan T N Tita; Mark B Landon; Catherine Y Spong; Yinglei Lai; Kenneth J Leveno; Michael W Varner; Atef H Moawad; Steve N Caritis; Paul J Meis; Ronald J Wapner; Yoram Sorokin; Menachem Miodovnik; Marshall Carpenter; Alan M Peaceman; Mary J O'Sullivan; Baha M Sibai; Oded Langer; John M Thorp; Susan M Ramin; Brian M Mercer Journal: N Engl J Med Date: 2009-01-08 Impact factor: 91.245