[Respiratory dysfunction in infants born by elective cesarean section without labor].
OBJECTIVE
To evaluate the effects of gestational age at the timing of elective caesarean section (ECS) on the incidence of respiratory dysfunction in the newborn.


METHODS
This was a retrospective study. All infants born by ECS at the Landspitali-University Hospital Iceland over a 10 years period (1996-2005) at >or=37 weeks gestation and diagnosed with transient tachypnoea of the newborn (TTN) or respiratory distress syndrome (RDS) were included in the study.


RESULTS
Of the 1486 infants delivered by ECS over the study period 57 (3.8%) developed TTN (50 infants) or RDS (7 infants). The incidence of respiratory dysfunction was inversely related to gestational age, 13.8% at 37 weeks gestation and 2.5% at 40 weeks gestation. A statistically significant reduction in the incidence of TTN or RDS was observed from 38 weeks to 39 weeks gestation (6.6% and 2.3% respectively; p<0.001). There has been a reduction in the incidence of ECS before 39 weeks gestation since 2001, when guidelines regarding optimal timing of ECS were set at our hospital.


CONCLUSIONS
The incidence of respiratory dysfunction in neonates born by ECS is inversely related to gestational age, even in the term infant. It is important to delay ECS until 39 weeks gestation whenever possible, in order to minimize the risk of respiratory dysfunction in the newborn infant.
Dónaldsson
Snorri Freyr
SF
Barnaspítala Hringsins, Landspítala.
Dagbjartsson
Atli
A
Bergsteinsson
Hördur
H
Hardardóttir
Hildur
H
Haraldsson
Asgeir
A
Thórkelsson
Thórdur
T
D002585:Cesarean Section / Q000009:adverse effects* / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D005865:Gestational Age; D019983:Guideline Adherence; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D015994:Incidence; D007231:Infant, Newborn; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011787:Quality of Health Care; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies