Birth weight-specific fetal deaths and neonatal mortality and the rising cesarean section rate.
To address the question of what effect the rising cesarean section rate has on fetal and neonatal mortality, 33,843 births and 4,132 sections were studied at a community hospital (1968-1987). Crude fetal and neonatal mortality rates declined as the annual section rate rose from 4.7% to 25.7%. However, weight-specific mortality rates bore little relationship to weight-specific section rates. Neonatal mortality rates for infants weighing over 2499 g and without congenital anomalies remained essentially the same (.91, 1.0, 1.02 per 1000 live births) for each of the five-year periods included in the study, despite marked increases in section rates. Among fetal deaths in this weight group, only antepartum deaths declined in each period. This analysis of birth weight-specific mortality indicates that a five-fold rise in the annual cesarean section rate has contributed little, if anything, to reductions in fetal and neonatal mortality during this time.
Sepkowitz
S
S
University of Oklahoma Health Sciences Center, Oklahoma City.
D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004420:Dystocia / Q000401:mortality* / Q000517:prevention & control; D005260:Female; D005313:Fetal Death / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D009825:Oklahoma / Q000453:epidemiology; D011247:Pregnancy