Timing of elective repeat caesarean does matter: Importance of avoiding early-term delivery especially in diabetic patients

Abstract

Five hundred and three elective repeat caesarean sections were analysed to examine the impact of timing of delivery between 37 and 40 weeks’ gestation on foetal and maternal short-term outcome. Gestational age, Apgar scores and admission to the neonatal intensive care unit (NICU)-based foetal outcome. Maternal complications were comparatively evaluated. Due to the increasing incidence of gestational diabetes a subgroup analysis on this issue was performed. Neonates born by elective repeat caesarean in early term had a 3.2 times increased risk of being admitted to the NICU due to foetal adaption disorders in the early post-natal phase. Overall maternal peri-operative risks were low and did not differ significantly between 37 and 41 weeks’ gestation. Maternal gestational diabetes constituted an additional independent risk factor in early term. In summary, elective early-term caesarean delivery appears to negatively impact immediate neonatal outcome. Waiting at least until 38 completed weeks’ gestation improves foetal outcome, especially in diabetic patients.

Keywords::

• Diabetes
• elective repeat caesarean
• foetal outcome
• maternal risk
• neonatal intensive care unit

Acknowledgements

The Medical Faculty of the University of Heidelberg provided support for these studies by accepting Dr. Stephanie Gawlik as a stipendiary.

Declaration of interest: The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.