Cesarean delivery and respiratory distress syndrome: does labor make a difference?
OBJECTIVE
The purpose of this study was to determine if cesarean delivery is a risk factor for respiratory distress syndrome (RDS) and if this risk is modified by labor before cesarean.


METHODS
This population-based case-control study compared 4778 cases of RDS to 5 times as many controls.


RESULTS
Unadjusted, cesarean delivery was associated with RDS, odds ratio (OR) 3.5 (95% CI 3.2-3.8). After controlling for potential confounding variables, cesarean remained an independent risk factor, OR 2.3 (95% CI 2.1-2.6). Labor modified this risk significantly (P = .02)--with labor, cesarean delivery had an OR of 1.9 (95% CI 2.2-2.9), without labor, the OR was 2.6 (95% CI 1.3-2.8).


CONCLUSIONS
Cesarean delivery was an independent risk factor for RDS. The risk was reduced with labor before cesarean, but still elevated. This supports the importance of being certain of fetal lung maturity before cesarean delivery, particularly when done before labor.
Gerten
Kim A
KA
Department of Obstetrics, Gynecology & Women's Health, Maricopa Integrated Health System, MedPro, Phoeniz, AZ, USA.
Coonrod
Dean V
DV
Bay
R Curtis
RC
Chambliss
Linda R
LR
D016022:Case-Control Studies; D002585:Cesarean Section; D015986:Confounding Factors, Epidemiologic; D017558:Elective Surgical Procedures; D005260:Female; D005325:Fetal Organ Maturity; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D008168:Lung / Q000196:embryology; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology*; D014219:Trial of Labor