Respiratory distress syndrome after elective caesarean section in near term infants: a 5-year cohort study

Abstract

Objective: to assess the incidence of respiratory distress syndrome (RDS) in late preterm (34^0/7–36^6/7) and just term (37^0/7–37^6/7) infants born via elective caesarean section (CS) in a tertiary care maternity facility.

Methods: retrospective cohort study between 2005 and 2009. Hundred and eighty-eight near term infants, divided in two groups: group A: 125 late preterm (34^0/7–36^6/7) and group B: 63 just term (37^0/7–37^6/7), from elective CS (except CS after pre-mature rupture of membranes and foetuses presenting congenital malformation) were included.

Results: In group A the overall incidence of RDS (RDS at or shortly after birth, requiring respiratory support or oxygen therapy) was 44% (n = 55) vs. 15.9% (n = 10) in group B (p < 0.01). The incidence of SRDS (requiring admission in the neonatal intensive care unit (NICU)) in group A was 13.6% (n = 17) and 3.2% (n = 2) group B (p < 0.01). The risk decreased significantly as gestational age (GA) increased: for RDS, 50.9% at 34 weeks of gestation (WG), 52.5% at 35 WG, 21.5% at 36 WG, and 15.9% at 37 WG; for admission, 30.2% at 34 WG, 25% at 35 WG, 9.4% at 36 WG, and 6.3% at 37 WG. Among late preterm infants with RDS, 30.9% (n = 17) developed severe RDS (SRDS).

Conclusions: Late preterm infants born via elective CS are at high risk for RDS and NICU admission. The risk is influenced by each additional week spent in utero. As the incidence of CS is increasing within this population, new preventative strategies must be sought.

Keywords::

• Antenatal corticosteroid therapy
• elective caesarean section
• late preterm
• preterm birth
• respiratory distress syndrome

Acknowledgements

The authors thank Ms Elisabeth Jouve (CIC-CPCET, AP-HM la Timone, Marseille, France) for the statistical analysis. This study has been examined and approved by the Ethic Comity of Research in Obstetrics and Gynaecology (CEROG). N° IRB 2010–19.

Declaration of Interest: The authors report no declaration of interest