title: Risks and benefits of the skin-to-skin cesarean section - a retrospective cohort study.
abstract: OBJECTIVE
  Comparing maternal and neonatal outcomes after conventional cesarean section (CS) versus a "natural" or "skin-to-skin" cesarean section (SSCS).
  
  
  METHODS
  Retrospective cohort of women who underwent a SSCS (01-2013 until 12-2013) compared to conventional CS (08-2011 to 08-2012). CS before 37 weeks, under general anesthesia and in case of fetal distress were excluded. Main outcome measures were maternal blood loss, post-operative infection and admission; neonatal infection and admission; procedural outcomes.
  
  
  RESULTS
  We analyzed 285 (44%) women in the SSCS-group and 365 (56%) in the conventional CS-group. There were no significant differences in surgical site infection (2.1% versus 1.6%; RR 1.1; 95%CI 0.64-2.0), or other maternal outcomes. Fewer neonates born after SSCS were admitted to the pediatric ward (9.5% versus 18%; RR 0.58; 95%CI 0.41-0.80) and fewer neonates had a suspected neonatal infection (2.0% versus 7.3%; RR 0.40; 95%CI 0.19-0.83). No differences were observed for other outcomes. Mean operation time was 4m42s longer in the SSCS-group compared to the conventional CS-group (58m versus 53m; 95%CI 2m44s-6m40s). Mean recovery time was 14m46s shorter (114m versus 129m; 95%CI 3m20s-26m).
  
  
  CONCLUSIONS
  Adverse maternal and neonatal outcomes were not increased after skin-to-skin cesarean compared to conventional cesarean delivery.
authors.affiliation: a Department of Obstetrics and Gynecology.
authors.forename: Selina
authors.initials: S
authors.lastname: Posthuma
authors.affiliation: a Department of Obstetrics and Gynecology.
authors.forename: Fleurisca J
authors.initials: FJ
authors.lastname: Korteweg
authors.affiliation: a Department of Obstetrics and Gynecology.
authors.forename: J Marinus
authors.initials: JM
authors.lastname: van der Ploeg
authors.affiliation: b Department of Anesthesiology and Pain medicine , and.
authors.forename: Hans D
authors.initials: HD
authors.lastname: de Boer
authors.affiliation: c Department of Pediatrics , Martini Hospital , Groningen , the Netherlands.
authors.forename: Hannah D
authors.initials: HD
authors.lastname: Buiter
authors.affiliation: a Department of Obstetrics and Gynecology.
authors.forename: David P
authors.initials: DP
authors.lastname: van der Ham
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D060127:Kangaroo-Mother Care Method; D061646:Operative Time; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D018570:Risk Assessment; D058636:Surgical Drapes; D013530:Surgical Wound Infection / Q000209:etiology
keywords: Benefits; complications; maternal and neonatal outcome; natural cesarean section; skin-to-skin cesarean