Early cesareans put babies at risk
Women choosing repeat cesarean deliveries and having them before completing 39 weeks gestation, without there being any medical reason for delivering early, risk serious complications for their baby. So says a University of Alabama study which reveals that scheduling a repeat cesarean at 37 or 38 weeks means you’re up to two times more likely to have a baby with serious complications including respiratory distress resulting in mechanical ventilation and NICU admission.
“The cesarean rate in the US has risen dramatically, from 20.7% in 1996 to 31.1% in 2006,” says Alan Tita, MD, Ph.D, assistant professor in the UAB Department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine. “A major reason is the decline in attempted vaginal births after cesarean. Because elective cesareans can be scheduled to accommodate patient and physician convenience, there is a risk that they may be performed earlier than is appropriate.
Dr Tita and colleagues studied 13,258 women who had elective repeat cesarean sections from 1999 through 2002, looking at whether an infant who was delivered at 37 weeks later died or was diagnosed with a number of conditions, including respiratory distress syndrome and seizures, needed ventilator support within 24 hours of birth, had an Apgar score at five minutes of three or below, was admitted to a neonatal intensive care unit or required prolonged hospitalization.
Of the 13,258 women who had elective repeat cesarean sections, as many as 35.8% were delivered before 39 weeks. Babies born at 37 weeks, were two times more likely to suffer with conditions common to babies born too soon, and at 38 weeks, they were one and a half times more likely.
Dr Tita says these findings, along with other studies, underscore the importance of not delivering a baby before 39 weeks for the sake of convenience. “Unfortunately, these early deliveries are associated with a preventable increase in neonatal morbidity and NICU admissions, which carry a high personal and economic cost. These findings support recommendations to delay elective delivery until 39 weeks gestation and should be helpful in counseling women on the necessity of waiting to deliver.”
The study was published January 8 in the New England Journal of Medicine.