title: Timing of elective cesarean delivery at term and its impact on maternal and neonatal outcomes among Thai and other Southeast Asian pregnant women.
abstract: OBJECTIVE
  The impact of timing of elective cesarean delivery (CD) at term on maternal and neonatal outcomes among Thai and other Southeast Asian pregnancies was investigated. The rate of spontaneous labor before the scheduled CD, as well as maternal characteristics predicting spontaneous labor, was also evaluated.
  
  
  METHODS
  Data on maternal and neonatal outcomes of 1221 singleton pregnancies scheduled for either an elective repeat CD or an elective primary CD at 37-40 weeks of gestation were studied. The association between maternal characteristics and the risk of spontaneous labor was evaluated by univariate and multivariate analyses.
  
  
  RESULTS
  There were no significant differences in severe maternal complications between performing an elective CD at 39 weeks and at the other gestational ages. Severe neonatal complications were significantly decreased when a CD was performed electively from 38 weeks onwards. A total of 503 women (41.2 %) went into spontaneous labor before the scheduled CD. Using 39 weeks as the reference group, scheduling a CD at 37 or 38 weeks decreased the risk of spontaneous labor (6.67-fold and 4.55-fold, respectively) while scheduling a CD at 40 weeks had a 2.54-fold increased risk. A history of previous CD and teenage pregnancy were also predictors of spontaneous labor; adjusted odds ratios were 14.27 and 3.93, respectively.
  
  
  CONCLUSIONS
  The timing of elective CD at term had impacts on pregnancy outcomes among Thai and other Southeast Asian women. Gestational age at scheduled CD, a previous CD and teenage pregnancy were predictors of spontaneous labor.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
authors.forename: Chadakarn
authors.initials: C
authors.lastname: Phaloprakarn
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
authors.forename: Siriwan
authors.initials: S
authors.lastname: Tangjitgamol
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
authors.forename: Sumonmal
authors.initials: S
authors.lastname: Manusirivithaya
mesh_terms: D000293:Adolescent; D000328:Adult; D001210:Asia, Southeastern; D002585:Cesarean Section / Q000009:adverse effects; D017604:Cesarean Section, Repeat; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence; D012189:Retrospective Studies; D047929:Term Birth; D013785:Thailand; D055815:Young Adult
keywords: elective cesarean delivery; maternal outcomes; neonatal outcomes; term pregnancy