A study of respiratory disorders in neonates in emergency caesarean section, elective caesarean section and normal vaginal delivery at term (original) (raw)
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Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study
BMJ, 2008
Objective To investigate the association between elective caesarean sections and neonatal respiratory morbidity and the importance of timing of elective caesarean sections. Design Cohort study with prospectively collected data from the Aarhus birth cohort, Denmark. Setting Obstetric department and neonatal department of a university hospital in Denmark. Participants All liveborn babies without malformations, with gestational ages between 37 and 41 weeks, and delivered between 1 January 1998 and 31 December 2006 (34 458 babies). Main outcome measures Respiratory morbidity (transitory tachypnoea of the newborn, respiratory distress syndrome, persistent pulmonary hypertension of the newborn) and serious respiratory morbidity (oxygen therapy for more than two days, nasal continuous positive airway pressure, or need for mechanical ventilation). Results 2687 infants were delivered by elective caesarean section. Compared with newborns intended for vaginal delivery, an increased risk of respiratory morbidity was found for infants delivered by elective caesarean section at 37 weeks' gestation (odds ratio 3.9, 95% confidence interval 2.4 to 6.5), 38 weeks' gestation (3.0, 2.1 to 4.3), and 39 weeks' gestation (1.9, 1.2 to 3.0). The increased risks of serious respiratory morbidity showed the same pattern but with higher odds ratios: a fivefold increase was found at 37 weeks (5.0, 1.6 to16.0). These results remained essentially unchanged after exclusion of pregnancies complicated by diabetes, pre-eclampsia, and intrauterine growth retardation, or by breech presentation. Conclusion Compared with newborns delivered vaginally or by emergency caesarean sections, those delivered by elective caesarean section around term have an increased risk of overall and serious respiratory morbidity. The relative risk increased with decreasing gestational age.
Influence of Mode of Delivery at Term on the Neonatal Respiratory Morbidity
Objective: Respiratory morbidity is an important complication of elective cesarean section. Our objective was to find out the incidence of respiratory distress in term neonates delivered by elective cesarean section and compare it with neonates delivered vaginally. Methodology: We evaluated one thousands infants delivered by elective cesarean section and normal vaginal delivery for respiratory distress. Results: Among 500 cesarean done, 27 (5.4%) neonates had respiratory distress and among 500 vaginal delivery infants, 8(1.6%) developed respiratory Distress (P<0.001).
Neonatal respiratory morbidity after elective cesarean section
Journal of Maternal-fetal & Neonatal Medicine, 2006
Objective. The objective of this study was to examine the rate of respiratory morbidity in neonates delivered by elective cesarean delivery (ECD) at term, with a definite confirmation of gestational age (GA) by 1st-trimester ultrasound. Methods. Consecutive women carrying a singleton pregnancy and undergoing ECD at term (438 1/7 weeks), confirmed by 1st-trimester ultrasound, were included in the study group. Multiple gestations, cesarean section (CS) in labor, CS performed after rupture of membranes and induced deliveries were excluded. The control group included women with a singleton pregnancy at term (438 1/7 weeks) who delivered spontaneously. This group of women was randomly selected during the study period. Results. The study group included 277 women delivered by ECD. The control group consisted of 311 women. Five newborns in the study group and none in the control group were admitted to the neonatal intensive care unit (NICU) due to respiratory disorders (p 5 0.02). Excluding diabetic women did not change the results. On multivariate analysis, no other factors were found to independently influence the risk of respiratory complications. Conclusion. In our study, the rate of respiratory morbidity was found to be significantly higher in neonates delivered by ECD compared to those delivered vaginally. The fact that GA was confirmed by 1st-trimester ultrasound makes iatrogenic prematurity an unlikely sole cause for this excess morbidity.
Neonatal respiratory morbidity following elective caesarean section in term infants
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2001
Respiratory morbidity is an important complication of elective caesarean section. The presence of labour preceding caesarean section reduces the risk of neonatal respiratory morbidity. Recently, it has been shown that the incidence of respiratory morbidity is lower in infants with a gestational age of at least 39 0 weeks at elective caesarean section compared to infants with a gestational age less than 39 0 weeks. This article describes the results of a 5-year retrospective study on the incidence of respiratory distress in term neonates delivered by elective caesarean section in relation to gestational age and provides a literature review on neonatal respiratory morbidity following elective caesarean section. #
Risk of respiratory morbidity in term infants delivered by elective cesarean delivery
International Journal of Medical Science and Public Health, 2016
Background: The incidence of elective cesarean delivery (ECD) at term is rapidly increasing in the last decades, which is significantly contributing to neonatal respiratory morbidity. Objective: To study the risk of respiratory morbidity in neonates delivered by ECD at term. Material and Methods: Descriptive prospective hospital-based study involving 511 women who delivered by ECD at term in Khartoum Teaching Hospital (KTH) and Omdurman Maternity Hospital (OMH). The cases of this study include all singleton neonates born to mothers delivered by ECD at (37-40 weeks) of gestation at OMH and KTH between April 1, 2010, and February 28, 2011. The study cases were neonates born to mothers delivered by ECD at 37-40 weeks' gestation. Cases were matched for gestational age, maternal age, parity, baby weight, and maternal body weight. Apgar score and examination of the neonates were carried out and recorded by the pediatric team. Result: The majority of women recruited in this study delivered at 38-39 weeks' gestational age, and their ages were between 26 and 30 years. Results showed that most of the babies delivered with weight <2.5 kg had increased respiratory morbidity. Also, there were some differences in outcome regarding neonatal gender having respiratory morbidity; boys were found to be more affected than girls. Finally, the results showed that 7.2% of the delivered babies had respiratory problems. Conclusion: Neonatal respiratory morbidity has been shown to be decreased with increasing gestational age and increasing neonatal weight in ECD at term.
Timing of Elective Cesarean Delivery at Term and Neonatal Respiratory Morbidity
Medico research chronicles, 2018
Aim To investigate the association between elective cesarean sections and neonatal respiratory morbidity and the importance of timing of elective cesarean sections Methods Cohort study with prospectively collected data of all elective Caesarean sections on mothers with a gestational age of 37+0 weeks and more, that were performed in our Hospital from 1 January 2011 to 1 January 2017. Multiple pregnancies, fetuses with congenital anomalies, intrauterine deaths, and emergency Caesarean sections were excluded. Primary outcome measures of neonatal respiratory morbidity included transient tachypnea of newborn, respiratory distress syndrome, persistent pulmonary hypertension of the newborn. Results 4290 infants were delivered by elective cesarean section at 37+0 and then after Compared with newborns from vaginal delivery, and emergency cesarean section an increased risk of respiratory morbidity was found for infants delivered by elective cesarean section at 37 +0 weeks' gestation to 37+6 weeks (odds ratio 4.5 95% confidence interval 3.3 to 6.3), 38+0 weeks' gestation to 38+6 weeks (2.7 , 1.9 to 3.6), and 39+0 weeks' gestation (2.1, 1.6 to 3.0). Also increasing the incidence of admission to the NICU with decreasing gestational age at term birth below the 39 weeks of gestation Conclusions: Compared with newborns delivered vaginally or by emergency cesarean sections, those delivered by elective cesarean section around term have an increased risk of respiratory morbidity. The relative risk increased with decreasing gestational age.
Journal of SAFOG, 2017
Objectives: (1) To investigate the association between term elective cesarean sections and neonatal respiratory morbidity and the importance of timing of the cesarean. (2) To assess the maternal morbidity when emergency lower segment cesarean section (LSCS) was required. Participants: All women with singleton term (37-41 + 6 weeks) pregnancies and planned for elective cesarean section in Christian Medical College, Vellore, India. Outcome measures: The primary outcome measures were neonatal morbidities such as transient tachypnea of newborn (TTN) and respiratory distress syndrome (RDS). The secondary outcome measures were emergency cesarean section and maternal morbidities such as scar dehiscence, urinary tract infection (UTI), endometritis, peritonitis, and hemoperitoneum in the mother. Results: The percentage of TTN in the infants in group I was 1.3% while there were none in group II. No infants were diagnosed to have RDS. Out of the 150 women who were planned for elective cesarean section, 55 women underwent emergency cesarean section. Among this, 19 (25.3%) of women were from group I as compared with 36 (48.0%) in group II. The difference in proportion between the two groups was −22.7 [95% confidence interval (CI): −37.7, −7.7], which was statistically significant (p < 0.01). The incidence of scar dehiscence, UTI, endometritis, and hemoperitoneum in the mothers of group II was marginally higher than that in the mothers of group I. There was one woman with peritonitis in group I while none was reported in the other group. All the maternal morbidities occurred to women who underwent emergency cesarean section. Out of the 19 women in group I and 36 women in group II who underwent emergency cesarean section, 1 (5.3%) and 6 (16.7%) women had morbidities. Conclusion: Women requiring elective cesarean section can safely be done between 37 and 39 weeks with no further significant increase in the rates of neonatal morbidity such as TTN and RDS.
Frontiers in Pediatrics, 2020
Background: Cesarean section (CS) is one of the most recurrently carried out surgical procedures in modern obstetrics. Worldwide, about 18.5 million CSs are conducted annually. Of this, 21-33% are performed in middle-and high-income countries. The effectiveness of the CS in preventing maternal and prenatal mortality and morbidity is medically justifiable. However, cesarean delivery without demanding obstetrical indications, by mere maternal request, may expose the child to several risks over benefits. Therefore, we aim to compare spontaneous vaginal delivery (vaginal delivery other than operative vaginal deliveries) and elective CS (CS before the onset of labor, but not including emergency CS) in decreasing the risk of neonatal respiratory morbidity. Objective: To compare the risk of neonatal respiratory morbidity in ECS and spontaneous vaginal delivery. Methods: A literature search was performed through visiting an electronic database (MEDLINE, PubMed, EMBASE, and CINAHL) and gray literature sources, including Google and Google Scholar, from January 2000 to May 2018. Original observational studies that reported the risk of neonatal respiratory morbidity in relation to mode of delivery conducted in the English language were identified and screened. Joanna Briggs Institute's quality assessment tool for observational studies was used to critically appraise the methodological quality of studies. Synthesis of individual studies was conducted using the Review Manager Software version 5.3 for Windows. Heterogeneity among studies was explored using the Cochran's Q-test and the I 2 statistics. Pooled effect sizes in relative risk ratios with 95% confidence intervals were calculated. The flow of the study was prepared according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) checklist. Tefera et al. ECS Is Risk for Neonatal Respiratory Morbidity Results: Sixteen studies were reviewed. A total of 327,272 neonates born by vaginal delivery and 55,246 born by ECS were included in this study. The risk of neonatal respiratory morbidity was increased by 95% in neonates delivered by ECS (RR = 1.95; 95% CI: 1.40-2.73) as compared with neonates born by spontaneous vaginal delivery. Conclusion: This study investigated the effect of mode of delivery on the respiratory morbidity without considering other risks and found that the ECS has a high risk of developing neonatal respiratory morbidities when compared to spontaneous vaginal delivery. So, we recommend discouraging unnecessary CS. registration: CRD42018104905.