Repeat Elective Caesarean Before 39 Weeks Increases Neonatal Risk

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If a woman who has had a Caesarean delivery has another such elective procedure before 39 weeks of gestation, the risk of an adverse neonatal outcome increases by 50% or more ...

A repeat elective Caesarean at 38 weeks was associated with an odds ratio of 1.5 for adverse outcomes, increasing to 2.1 for Caesarean delivery at 37 weeks ...

Adverse respiratory outcomes, need for mechanical ventilation, newborn sepsis, hypoglycemia, admission to the neonatal ICU, and hospitalization for five days or longer all occurred more often in babies delivered by Caesarean before 39 weeks of gestation.

"These early deliveries are associated with a preventable increase in neonatal morbidity and admissions to the neonatal ICU, which carry a high economic cost," the authors concluded. "These findings support recommendations to delay elective delivery until 39 weeks of gestation and should be helpful in counseling."

... Approximately 40% of Caesarean deliveries are repeat procedures. As the number of procedures increases, so do the public health implications related to the timing of delivery ...

... Compared with births at 39 weeks, births at 37 weeks had more than a two-fold increased risk of the primary outcome (OR 2.1, 95% CI 1.7 to 2.5). For births at 38 weeks, the hazard remained increased (OR 1.5, 95% CI 1.3 to 1.7) ...

The authors noted that they "also observed a higher risk of neonatal complications with Caesarean delivery at 41 weeks or later although the overall proportion of mothers delivering this late was small (<5%)."

Melissa Maimann, Essential Birth Consulting 0400 418 448