The timing of elective caesarean deliveries and early neonatal outcomes in singleton infants born 37-41 weeks' gestation

Doan, Emily, Gibbons, Kristen and Tudehope, David (2014) The timing of elective caesarean deliveries and early neonatal outcomes in singleton infants born 37-41 weeks' gestation. Australian and New Zealand Journal of Obstetrics and Gynaecology, 54 4: 340-347. doi:10.1111/ajo.12220


Author Doan, Emily
Gibbons, Kristen
Tudehope, David
Title The timing of elective caesarean deliveries and early neonatal outcomes in singleton infants born 37-41 weeks' gestation
Journal name Australian and New Zealand Journal of Obstetrics and Gynaecology   Check publisher's open access policy
ISSN 0004-8666
1479-828X
Publication date 2014
Year available 2014
Sub-type Article (original research)
DOI 10.1111/ajo.12220
Open Access Status
Volume 54
Issue 4
Start page 340
End page 347
Total pages 8
Place of publication Richmond, VIC Australia
Publisher Blackwell Publishing
Collection year 2015
Language eng
Abstract Background Births by elective caesarean section (CS) are rising, particularly before 39 weeks' gestation, which may be associated with unacceptably high risk of adverse neonatal outcomes. The optimal timing of these deliveries needs to be determined with recent recommendations to delay births by elective CS until 39 weeks. Aims To evaluate the association between gestational age (GA) at delivery and neonatal outcomes after elective CS between 37 and 41 weeks. Materials and Methods Retrospective cohort study of viable singleton neonates delivered by elective CS at Mater Mothers' Hospitals (1998-2009). Neonates were stratified into two GA groups with early term (ET, 37-38 weeks) compared with the reference group of full and late term (FLT, 39-41 weeks). The primary outcome examined was serious respiratory morbidity; secondary outcomes included depression at birth, nursery admission and assisted ventilation. Results Fourteen thousand and four hundred and forty-seven mother-baby pairs were included (59.9% delivered before 39 weeks). There was a significantly decreasing risk of adverse neonatal outcomes with increasing GA. Compared to FLT, delivery at ET almost tripled the risk of the primary outcome (AOR 2.74; 95% CI 1.79-4.21). Rates of most secondary outcomes were at least doubled. Conclusion Elective CS performed at 37-38 weeks is associated with poorer neonatal outcomes compared to those delivered at 39-41 weeks. This study supports recent recommendations to delay delivery by elective CS until week 39 if possible.
Keyword Caesarean section
Elective
Infant
Morbidity
Neonatal mortality
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 19 MAY 2014

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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