Timing of elective repeat cesarean delivery at term and neonatal outcomes: a cost analysis.
OBJECTIVE
The purpose of this investigation was to examine the economic impact of performing elective repeat cesarean during 37 or 38 weeks of gestation relative to the American College of Obstetricians and Gynecologists recommendation of a 39-week delivery.


METHODS
Decision analysis modeling was used to estimate economic outcomes for a hypothetical cohort of neonates using data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network study of "Timing of Elective Repeat Cesarean Delivery at Term and Neonatal Outcomes." Costs and charges were estimated using the Florida Healthcare Cost and Utilization Project.


RESULTS
A total of 82,541 deliveries occurring between 37-39 completed weeks of gestation were analyzed for the incidence of adverse outcomes and their hospital costs and charges. The model demonstrated increased costs through increasing adverse outcomes among elective repeat cesarean deliveries performed <39 weeks of gestation.


CONCLUSIONS
Our findings suggest that there are benefits to waiting until 39 weeks of gestation to perform an elective repeat cesarean delivery.
Robinson
Christopher J
CJ
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA.
Villers
Margaret S
MS
Johnson
Donna D
DD
Simpson
Kit N
KN
D017604:Cesarean Section, Repeat / Q000009:adverse effects / Q000191:economics*; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis / Q000191:economics; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000191:economics*; D005260:Female; D005431:Florida; D005865:Gestational Age; D006801:Humans; D015931:Intensive Care, Neonatal / Q000191:economics*; D007902:Length of Stay / Q000191:economics; D018803:Models, Economic; D011247:Pregnancy; D011256:Pregnancy Outcome; D013997:Time Factors