Neonatal respiratory morbidity after elective cesarean section.
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 (>38 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 (>38 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 < 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.


CONCLUSIONS
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.
Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. many@post.tau.ac.il
Ariel
A
Many
Limor
L
Helpman
Yael
Y
Vilnai
Michael J
MJ
Kupferminc
Joseph B
JB
Lessing
Shaul
S
Dollberg
D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects*; D017558:Elective Surgical Procedures; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology*; D012307:Risk Factors; D016216:Ultrasonography, Prenatal