Neonatal outcome following elective cesarean section beyond 37 weeks of gestation: a 7-year retrospective analysis of a national registry.
OBJECTIVE
We sought to evaluate number and timing of elective cesarean sections at term and to assess perinatal outcome associated with this timing.


METHODS
We conducted a recent retrospective cohort study including all elective cesarean sections of singleton pregnancies at term (n = 20,973) with neonatal follow-up. Primary outcome was defined as a composite of neonatal mortality and morbidity.


RESULTS
More than half of the neonates were born at <39 weeks of gestation, and they were at significantly higher risk for the composite primary outcome than neonates born thereafter. The absolute risks were 20.6% and 12.5% for birth at <38 and 39 weeks, respectively, as compared to 9.5% for neonates born > or = 39 weeks. The corresponding adjusted odds ratios (95% confidence interval) were 2.4 (2.1-2.8) and 1.4 (1.2-1.5), respectively.


CONCLUSIONS
More than 50% of the elective cesarean sections are applied at <39 weeks, thus jeopardizing neonatal outcome.
Wilmink
Freke A
FA
Department of Obstetrics and Gynecology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
Hukkelhoven
Chantal W P M
CW
Lunshof
Simone
S
Mol
Ben Willem J
BW
van der Post
Joris A M
JA
Papatsonis
Dimitri N M
DN
D000328:Adult; D000367:Age Factors; D001034:Apgar Score; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D007363:Intensive Care Units, Neonatal; D020300:Intracranial Hemorrhages / Q000453:epidemiology; D009426:Netherlands / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D010298:Parity; D010343:Patient Admission / Q000706:statistics & numerical data; D011247:Pregnancy; D011654:Pulmonary Edema / Q000453:epidemiology; D044469:Racial Groups; D012042:Registries; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D012151:Resuscitation / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology; D018805:Sepsis / Q000453:epidemiology