Neonatal outcome following elective cesarean section beyond 37 weeks of gestation: a 7-year retrospective analysis of a national registry
Presented orally at the 30th Annual Meeting of the Society for Maternal-Fetal Medicine, Chicago, IL, Feb. 1-6, 2010.
Received 22 November 2009; received in revised form 28 December 2009; accepted 19 January 2010.
Refers to article:
Latest research from the 2010 meeting of the Society for Maternal-Fetal Medicine
Jay D. Iams
American Journal of Obstetrics & Gynecology
March 2010 (Vol. 202, Issue 3, Page 207) Full Text |
Full-Text PDF (81 KB)
Elective delivery before 39 weeks: reason for caution
George A. Macones
American Journal of Obstetrics & Gynecology
March 2010 (Vol. 202, Issue 3, Page 208) Full Text |
Full-Text PDF (94 KB)
Objective
We sought to evaluate number and timing of elective cesarean sections at term and to assess perinatal outcome associated with this timing.
Study Design
We conducted a recent retrospective cohort study including all elective cesarean sections of singleton pregnancies at term (n = 20,973) with neonatal follow-up. Primary outcome was defined as a composite of neonatal mortality and morbidity.
Results
More than half of the neonates were born at <39 weeks of gestation, and they were at significantly higher risk for the composite primary outcome than neonates born thereafter. The absolute risks were 20.6% and 12.5% for birth at <38 and 39 weeks, respectively, as compared to 9.5% for neonates born ≥39 weeks. The corresponding adjusted odds ratios (95% confidence interval) were 2.4 (2.1–2.8) and 1.4 (1.2–1.5), respectively.
Conclusion
More than 50% of the elective cesarean sections are applied at <39 weeks, thus jeopardizing neonatal outcome.
aDepartment of Obstetrics and Gynecology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands
bDepartment of Obstetrics and Gynecology, Amphia Hospital, Breda, The Netherlands
cThe Netherlands Perinatal Registry, Utrecht, The Netherlands
dDepartment of Obstetrics and Gynecology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
Cite this article as: Wilmink FA, Hukkelhoven CWPM, Lunshof S, et al. Neonatal outcome following elective cesarean section beyond 37 weeks of gestation: a 7-year retrospective analysis of a national registry. Am J Obstet Gynecol 2010;202:250.e1-8.
Reprints not available from the authors.
The racing flag logo above indicates that this article was rushed to press for the benefit of the scientific community.
ABSTRACT
Latest research from the 2010 meeting of the Society for Maternal-Fetal Medicine