title: An old problem revisited--hyaline membrane disease and Cesarean section.
abstract: The incidence of hyaline membrane disease (HMD) was investigated retrospectively in 159 preterm infants below 35 weeks gestation, weighing less than 2,000 g, and born during the 5-year interval 1975-79. The incidence of HMD was compared between infants delivered by elective Cesarean section, Cesarean section after the onset of labor and by the vaginal route. A significant difference (P less than 0.001) was found in the frequency of HMD dependent on the mode of delivery; 50% of infants delivered by elective Cesarean section developed HMD versus 19.2% in the vaginally delivered group. In infants delivered vaginally premature rupture of membranes (PROM) lowered the incidence of HMD to 5% compared to 32.4% in infants without PROM (P less than 0.01). When infants (less than 2,000 g) delivered vaginally without PROM were compared with those delivered by elective Cesarean section, no difference in HMD-incidence was observed. Out of 43 infants with birthweight above 2,000 g, who developed HMD during the 5-year period the majority had been delivered by elective Cesarean section. The possible effect of fetal stress on lung maturation is discussed.
mesh_terms: D001724:Birth Weight; D002585:Cesarean Section; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000150:complications / Q000453:epidemiology; D006801:Humans; D006819:Hyaline Membrane Disease / Q000453:epidemiology*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D011247:Pregnancy; D013548:Sweden