Timing of elective cesarean section and neonatal morbidity: a population-based study

Abstract

Purpose: To assess the incidence of neonatal complications related to gestational age at elective cesarean section near term.

Methods: We used a population-based dataset to compare neonatal outcomes by gestational age in uncomplicated singleton pregnancies delivered by elective cesarean section ≥37 weeks.

Results: A total of 7364 mothers had an elective cesarean during 2002–2012; 343 (4.7%) at 37, 21 753 (3.8%) at 38, 3140 (2.6%) at 39, 1718 (23.3%) at 40 and 410 (5.6%) at ≥41 weeks. Infants born at a lower gestational age had a higher rate of Apgar scores <7 (2%, 0.4%, 0.6%, 0,3%, 0.2% at 37, 38, 39, 40 and ≥41 week, p = 0.013), hypoglycemia (1.5%, 1.0%, 0.8%, 0.4%, 0.5% at 37, 38, 39, 40 and ≥ 41 week, p = 0.012), hyperbilirubinemia (12.2%, 9.5%, 6.4%, 4.8%, 4.1% at 37, 38, 39, 40 and ≥ 41 week, p < 0.001), respiratory distress syndrome (5.5%, 2.2%, 1.6%, 0.5%, 0.7% at 37, 38, 39, 40 and ≥ 41 week, p < 0.001), and neonatal intensive care admissions (8.7%, 2.3%, 1.9%, 1.0%, 1.7% at 37, 38, 39, 40 and ≥ 41 week, p < 0.001).

Conclusions: Elective cesarean section at ≥ 39 weeks gestation would significantly reduce neonatal complications.

Keywords:

• Elective cesarean section
• gestational age
• neonatal morbidity
• population-based study
• timing

Declaration of interest

All authors declare that we have no conflict of interest.