Timing of elective caesarean section at term on neonatal morbidities
Keywords:Cesarean section, Infant, newborn, Intensive care units, neonatal, Neonatal sepsis, Respiratory distress syndrome, newborn
Objective: To compare the incidence of neonatal morbidities with elective caesarean sections at different weeks of gestation in Hong Kong.
Methods: Medical records of all women with an elective caesarean section performed at gestational age ≥37 weeks in Queen Elizabeth Hospital, Hong Kong, between 1 January 2016 and 31 December 2018 were retrospectively reviewed. Adverse neonatal outcomes collected included respiratory distress syndrome, transient tachypnoea, persistent pulmonary hypertension, sepsis, and neonatal intensive care unit admission.
Results: A total of 1576 records were analysed. Overall, 74.68% of babies were delivered at 38 weeks’ gestation. The most common adverse neonatal outcome was transient tachypnoea (6.66%), followed by neonatal intensive care unit admission (5.90%), respiratory distress syndrome (5.26%), and sepsis (4.69%). Compared with babies born at 39 weeks’ gestation, those born at 37 weeks’ gestation were at increased risk of respiratory distress syndrome (odds ratio [OR]=5.438, p=0.024), neonatal intensive care unit admission (OR=3.938, p=0.027), a composite respiratory outcome (OR=3.402, p=0.007), and an overall composite outcome (OR=3.397, p=0.002).
Conclusion: Elective caesarean delivery at 37 weeks’ gestation is associated with higher risks of respiratory distress syndrome and neonatal intensive care unit admission, compared with elective caesarean delivery at 39 weeks’ gestation.
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