title: Neonatal morbidity after spontaneous labor onset prior to intended cesarean delivery at term: a cohort study.
abstract: BACKGROUND
  We aimed to investigate if labor onset before planned cesarean delivery (CD) affects the risk of neonatal admission, respiratory distress, or neonatal infectious morbidity.
  
  
  METHODS
  Our cohort included singleton term pregnant women with intended CD who delivered at Aarhus University Hospital from 1990 to 2012. Two groups of women were identified: women with intended CD performed before labor (nonlabor CD) and women with intended CD performed after spontaneous labor onset (labor-onset CD); in both groups there was no other maternal or fetal medical indication for an immediate CD or for early-term CD scheduling. Data were stratified in early-term (37-38 weeks) and full-term (39-40 weeks) deliveries. The main outcome measures were neonatal admission, respiratory distress and neonatal infectious morbidity.
  
  
  RESULTS
  Among 103 919 live births, 5071 deliveries were nonlabor CDs and 731 were labor-onset CDs. Compared to nonlabor CD, labor-onset CD was associated with similar risks of neonatal admission and respiratory distress, both at early and full term, but with a two- to three-fold increased risk of newborn septicemia or antibiotic treatment at early term. Labor onset at early term was associated with a lower risk of maternal blood loss of more than 500 mL, but with a higher risk of postoperative antibiotic treatment and endometritis.
  
  
  CONCLUSIONS
  Labor onset before planned CD was not associated with a decrease in neonatal respiratory morbidity, but may be associated with increased risks of neonatal infection.
authors.affiliation: Perinatal Epidemiology Research Unit, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.|Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Julie
authors.initials: J
authors.lastname: Glavind
authors.affiliation: Perinatal Epidemiology Research Unit, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.|Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Milidou
authors.affiliation: Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Uldbjerg
authors.affiliation: Perinatal Epidemiology Research Unit, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.|Center of Research in Rehabilitation (CORIR), Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Rikke
authors.initials: R
authors.lastname: Maimburg
authors.affiliation: Perinatal Epidemiology Research Unit, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.|Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Tine B
authors.initials: TB
authors.lastname: Henriksen
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000401:mortality*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007746:Labor Presentation; D011247:Pregnancy; D011295:Prenatal Care; D012042:Registries
keywords: Cesarean; infections; labor onset; neonatology; rupture of membranes