Alexandra Pires-Menard1,2, Christopher Flatley1,2, Sailesh Kumar1,2,3. 1. Mater Research Institute, University of Queensland, South Brisbane, Australia. 2. Faculty of Medicine, University of Queensland, Brisbane, Australia. 3. Mater Mothers' Hospital, South Brisbane, Australia.
Abstract
Objective: To describe the incidence of severe neonatal outcomes in infants delivered by emergency cesarean section (CS) at term and to identify risk factors predisposing to these outcomes. Methods: This was a retrospective study of women that underwent a term emergency CS at the Mater Hospital in Brisbane between January 2007 and April 2017. Neonatal outcomes was defined as a composite of Neonatal Intensive Care Unit (NICU) admission, severe acidosis, Apgar score ≤3 and 5 min, and death (intrapartum stillbirth and neonatal death). Results: The risk of adverse outcome was highest for infants born by emergency CS. They had lower median BW (3388 versus 3503 g, p < .001), were born later (40 versus 39 weeks, p = .02) and had higher odds of birth >41 + 0 weeks (aOR 1.34, 95% CI 1.187-1.52, p < .001) birth. Birth weight <5th centile was associated with a tripling and BW <10th centile a doubling of odds of the composite outcome. Indications for emergency cesarean births that had the highest odds for the severe composite outcomes were cord prolapse (aOR 3.06, 95% CI 1.87-5.01, p < .001), failed instrumental delivery (aOR 2.50, 95% CI 1.95-3.21, p < .001), and non-reassuring fetal status (NRFS) (aOR 2.39, 95% CI 2.13-2.69, p < .001).Conclusions: Emergency cesarean is associated with a greater risk of severe neonatal outcome; with low birth weight, an additional independent risk factor for poor condition at birth.
Objective: To describe the incidence of severe neonatal outcomes in infants delivered by emergency cesarean section (CS) at term and to identify risk factors predisposing to these outcomes. Methods: This was a retrospective study of women that underwent a term emergency CS at the Mater Hospital in Brisbane between January 2007 and April 2017. Neonatal outcomes was defined as a composite of Neonatal Intensive Care Unit (NICU) admission, severe acidosis, Apgar score ≤3 and 5 min, and death (intrapartum stillbirth and neonatal death). Results: The risk of adverse outcome was highest for infants born by emergency CS. They had lower median BW (3388 versus 3503 g, p < .001), were born later (40 versus 39 weeks, p = .02) and had higher odds of birth >41 + 0 weeks (aOR 1.34, 95% CI 1.187-1.52, p < .001) birth. Birth weight <5th centile was associated with a tripling and BW <10th centile a doubling of odds of the composite outcome. Indications for emergency cesarean births that had the highest odds for the severe composite outcomes were cord prolapse (aOR 3.06, 95% CI 1.87-5.01, p < .001), failed instrumental delivery (aOR 2.50, 95% CI 1.95-3.21, p < .001), and non-reassuring fetal status (NRFS) (aOR 2.39, 95% CI 2.13-2.69, p < .001).Conclusions: Emergency cesarean is associated with a greater risk of severe neonatal outcome; with low birth weight, an additional independent risk factor for poor condition at birth.
Authors: Jeong Ha Wie; Se Jin Lee; Sae Kyung Choi; Yun Sung Jo; Han Sung Hwang; Mi Hye Park; Yeon Hee Kim; Jae Eun Shin; Ki Cheol Kil; Su Mi Kim; Bong Suk Choi; Hanul Hong; Hyun-Joo Seol; Hye-Sung Won; Hyun Sun Ko; Sunghun Na Journal: Life (Basel) Date: 2022-04-18