title: Does cesarean section before the scheduled date increase the risk of neonatal morbidity?
abstract: BACKGROUND
  Previous studies led to the recommendation to schedule planned elective cesarean deliveries at or after 39 weeks of gestation and not before 38 weeks. The question is whether this practice is appropriate in face of possible risks to the newborn should the pregnancy have to be ended by cesarean section before the scheduled date.
  
  
  OBJECTIVE
  To compare the outcomes of newborn infants who were delivered on their scheduled day by elective cesarean section versus those who required delivery earlier.
  
  
  METHODS
  This single-center retrospective study was based on medical records covering a period of 18 months. We compared the neonatal outcomes of 272 infants delivered by elective cesarean section as scheduled (at 38.8 +/- 0.8 weeks gestation)and 44 infants who had to be delivered earlier than planned j(at 37.9 +/- 1.1 weeks).
  
  
  RESULTS
  We found no morbidity directly related to delivery by cesarean section before the scheduled date. There were no significant differences in the need for resuscitation after delivery. Although more of the infants who were delivered early were admitted to intensive care and overall stayed longer in the hospital (5.8 +/- 7.3 vs. 3.9 +/- 0.8 days, P < 0.02), their more severe respiratory illness and subsequent longer hospitalization was the result of their younger gestational age. Transient tachypnea of the newborn was associated with younger gestational age at delivery in both groups.
  
  
  CONCLUSIONS
  We suggest continuing with the current recommendation to postpone elective cesarean singleton deliveries beyond 38-39 weeks of gestation whenever possible.
authors.forename: Arieh
authors.initials: A
authors.lastname: Riskin
authors.forename: Ron
authors.initials: R
authors.lastname: Gonen
authors.forename: Amir
authors.initials: A
authors.lastname: Kugelman
authors.forename: Elias
authors.initials: E
authors.lastname: Maroun
authors.forename: Gregory
authors.initials: G
authors.lastname: Ekhilevitch
mesh_terms: D001034:Apgar Score; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D007557:Israel / Q000453:epidemiology; D007902:Length of Stay; D018743:Perinatal Care / Q000379:methods / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors