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181: Mode of delivery and neonatal respiratory morbidity in near-term preterm births

      Objective

      We reviewed respiratory complications for near-term (34 to 36 weeks) preterm births (PTB) at our institution based on mode of delivery.

      Study Design

      We performed a retrospective cohort analysis of our hospital′s perinatal and neonatal databases to identify all singleton near-term PTBs from 1998 to 2006. We compared respiratory complications for babies admitted to the NICU by mode of delivery.

      Results

      There were 2,222 near-term PTBs during the study period with 715 (32%) NICU admissions. The overall cesarean rate was 43%. There were significantly more short-term respiratory complications for those babies born by cesarean, as shown in the table.
      Tabled 1Respiratory Morbidity
      MorbidityVaginal Birth n=407Cesarean Birth n=308p
      Mechanical Ventilation15.2%25%.001
      Oxygen39.3%57.5%<.0001
      CPAP36.4%50.7%.0001
      RDS7.4%11.4%.06
      BPD0.7%2.0%.15

      Conclusion

      Recently, studies have reported an increasing rate of neonatal respiratory morbidity in near-term PTBs. The increased risk was attributed to the changing mode of delivery with an increasing cesarean rate. Our findings provide further evidence that mode of delivery significantly affects short-term neonatal respiratory complications.