Epidemiological analysis of the increased risk of disturbed neonatal respiratory adaptation after caesarean section.

In a prospective, unselected study of all 4,659 infants born in Göteborg, Sweden, risk factors for all kinds of neonatal respiratory disturbances (RD) after Caesarean section (CS) were analyzed. After CS, a significantly increased incidence rate of RD was found compared to vaginal delivery (24.6% vs. 5.5%). The increased overall risk affected full term infants only but IRDS was more common after CS in preterm infants. Rupture of membranes or uterine contractions prior to CS significantly reduced the incidence rate of RD in full term infants. Acute maternal complications did not affect the incidence. The elevated RD rate could partly be related to an increased incidence of low Apgar score after CS, and to absence of labour and rupture of membranes before the CS. But full term infants with Apgar score of 7 or more, delivered surgically after rupture of membranes and start of contractions, still had almost three times higher incidence of RD.