Kathryn J Macallister1, Lye W Tho1, Mathias Epee-Bekima2,3, Steven Resnick1,4,5, Jonathan W Davis6,7,8. 1. Neonatal Intensive Care Unit, Perth Children's and King Edward Memorial Hospitals, Perth, WA, Australia. 2. Division of Obstetrics and Gynaecology, University of Western Australia, Perth, WA, Australia. 3. Department of Obstetrics and Gynaecology, King Edward Memorial Hospital, Perth, WA, Australia. 4. Centre for Neonatal Research and Education, University of Western Australia, Perth, WA, Australia. 5. Newborn Emergency Transport Service, Perth Children's Hospital, Perth, WA, Australia. 6. Neonatal Intensive Care Unit, Perth Children's and King Edward Memorial Hospitals, Perth, WA, Australia. jonathan.davis@uwa.edu.au. 7. Centre for Neonatal Research and Education, University of Western Australia, Perth, WA, Australia. jonathan.davis@uwa.edu.au. 8. Newborn Emergency Transport Service, Perth Children's Hospital, Perth, WA, Australia. jonathan.davis@uwa.edu.au.
Abstract
OBJECTIVE: To determine whether 2006 Australian national guidance to delay elective caesarean section until 39 weeks' gestation would reduce the need for neonatal retrieval for respiratory compromise following elective caesarean. STUDY DESIGN: This is a retrospective cohort study comparing infants born by elective caesarean section who required retrieval for respiratory distress in Western Australia before and after the national guidance (2003-2006 vs. 2008-2014). RESULTS: The proportion of infants born by elective caesarean section who required retrieval for respiratory distress was reduced in the later cohort (0.77% (153/19 780) vs. 0.55% (227/40 875); p = 0.0012). The diagnosis of surfactant-deficient lung disease amongst retrieved infants was also reduced (26% (40/153) vs. 17.4% (40/227); p = 0.04). CONCLUSION: A reduction in the proportion of elective caesarean sections before 39 weeks in Western Australia was associated with a reduction in retrieval for respiratory compromise related to surfactant deficiency in infants born by elective caesarean section.
OBJECTIVE: To determine whether 2006 Australian national guidance to delay elective caesarean section until 39 weeks' gestation would reduce the need for neonatal retrieval for respiratory compromise following elective caesarean. STUDY DESIGN: This is a retrospective cohort study comparing infants born by elective caesarean section who required retrieval for respiratory distress in Western Australia before and after the national guidance (2003-2006 vs. 2008-2014). RESULTS: The proportion of infants born by elective caesarean section who required retrieval for respiratory distress was reduced in the later cohort (0.77% (153/19 780) vs. 0.55% (227/40 875); p = 0.0012). The diagnosis of surfactant-deficient lung disease amongst retrieved infants was also reduced (26% (40/153) vs. 17.4% (40/227); p = 0.04). CONCLUSION: A reduction in the proportion of elective caesarean sections before 39 weeks in Western Australia was associated with a reduction in retrieval for respiratory compromise related to surfactant deficiency in infants born by elective caesarean section.
Authors: Barbara Prediger; Anahieta Heu-Parvaresch; Stephanie Polus; Stefanie Bühn; Edmund A M Neugebauer; Pieper Dawid Journal: Syst Rev Date: 2021-06-14