title: Respiratory distress syndrome after elective caesarean section in near term infants: a 5-year cohort study.
abstract: OBJECTIVE
  to assess the incidence of respiratory distress syndrome (RDS) in late preterm (34(0/7)-36(6/7)) and just term (37(0/7)-37(6/7)) infants born via elective caesarean section (CS) in a tertiary care maternity facility.
  
  
  METHODS
  retrospective cohort study between 2005 and 2009. Hundred and eighty-eight near term infants, divided in two groups: group A: 125 late preterm (34(0/7)-36(6/7)) and group B: 63 just term (37(0/7)-37(6/7)), from elective CS (except CS after pre-mature rupture of membranes and foetuses presenting congenital malformation) were included.
  
  
  RESULTS
  In group A the overall incidence of RDS (RDS at or shortly after birth, requiring respiratory support or oxygen therapy) was 44% (n = 55) vs. 15.9% (n = 10) in group B (p < 0.01). The incidence of SRDS (requiring admission in the neonatal intensive care unit (NICU)) in group A was 13.6% (n = 17) and 3.2% (n = 2) group B (p < 0.01). The risk decreased significantly as gestational age (GA) increased: for RDS, 50.9% at 34 weeks of gestation (WG), 52.5% at 35 WG, 21.5% at 36 WG, and 15.9% at 37 WG; for admission, 30.2% at 34 WG, 25% at 35 WG, 9.4% at 36 WG, and 6.3% at 37 WG. Among late preterm infants with RDS, 30.9% (n = 17) developed severe RDS (SRDS).
  
  
  CONCLUSIONS
  Late preterm infants born via elective CS are at high risk for RDS and NICU admission. The risk is influenced by each additional week spent in utero. As the incidence of CS is increasing within this population, new preventative strategies must be sought.
authors.affiliation: Faculté de Médecine, Université de la Méditerranée-Assistance Publique Hôpitaux de Marseille, Pôle de Gynécologie-Obstétrique et Reproduction, Marseille, France. anaisbraubagne@gmail.com
authors.forename: Anais
authors.initials: A
authors.lastname: Berthelot-Ricou
authors.forename: Valérie
authors.initials: V
authors.lastname: Lacroze
authors.forename: Blandine
authors.initials: B
authors.lastname: Courbiere
authors.forename: Beatrice
authors.initials: B
authors.lastname: Guidicelli
authors.forename: Marc
authors.initials: M
authors.lastname: Gamerre
authors.forename: Umberto
authors.initials: U
authors.lastname: Simeoni
mesh_terms: D000222:Adaptation, Physiological; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D001623:Betamethasone / Q000008:administration & dosage; D002585:Cesarean Section / Q000009:adverse effects*; D003696:Delivery Rooms / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D005602:France / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D001623:Betamethasone