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[Cesarean delivery at term in low risk pregnancies: effects on neonatal morbidity].
Arch Argent Pediatr. 2010 Feb; 108(1):17-23.AA

Abstract

INTRODUCTION

The rate of cesarean delivery (CD) has significantly increased over the last years, even in low risk pregnancies. Our objective was to compare the neonatal morbidity rate in low risk term infants delivered by vaginal or CD.

DESIGN

Prospective observational and analytical cohort study. Main outcome measures. Incidence of any neonatal morbidity and respiratory morbidity. Population and methods. Infants < or = 37 weeks born at the Hospital Italiano de Buenos Aires between December 2004 and July 2006 were eligible. Exclusion criteria included: any maternal related disorder, acute or chronic fetal distress, breech presentation in primiparous women, multiple pregnancies, intrauterine growth restriction and newborns with major malformations.

RESULTS

A total of 2021 infants were included, 1120 born vaginally and 901 by CD. Main indications for CD were failure to progress labor (46%) and previous CD (37%). Only 3% of CD was performed by maternal request. Any neonatal morbidity rate was 9% in infants born by CD and 6.6% in infants born vaginally (RR 1.36; 95%CI 1.01-1.8). Respiratory morbidity rate was 5.3% in infants born by CD and 3.1% in those born vaginally (RR 1.7; 95%CI 1.1-2.6). When stratified by gestational age, respiratory morbidity was higher only for infants < or =38 weeks (7.4% in CD vs. 2.1% in vaginal delivery; RR 3.5; 95%CI 1.5-8.1). Also, respiratory morbidity was higher in infants born < or =38 weeks by CD without labor vs. those with labor 10.5% and 3.9%, respectively (RR 1.35; 95%CI: 1.07-1.70). In a logistic regression analysis, CD and male sex were independently associated with higher respiratory morbidity. There were not significant differences in other morbidities. NICU admission was higher in infants born by CD (9.5% vs. 6.1%; RR 1.5; 95% CI: 1.1-2.1). Sixty-eight percent of the mothers from the CD group refereed having moderate to severe pain in the puerperium vs. 36% in the vaginal group (RR 1.9; 95% CI: 1.7-2.1). Exclusive breastfeeding at discharge was significantly lower in infants born by CD (90% vs. 96%; RR 0.94 95%CI 0.92-0.96).

CONCLUSIONS

Low risk CD at term was associated with a higher neonatal morbidity, NICU admission and maternal pain in the puerperium. It also reduces exclusive breastfeeding rate at discharge.

Authors+Show Affiliations

Servicio de Neonatología, Departamento de Pediatría, Instituto Universitario, Hospital Italiano de Buenos Aires. jose.ceriani@hiba.org.arNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

spa

PubMed ID

20204235

Citation

Ceriani Cernadas, José M., et al. "[Cesarean Delivery at Term in Low Risk Pregnancies: Effects On Neonatal Morbidity]." Archivos Argentinos De Pediatria, vol. 108, no. 1, 2010, pp. 17-23.
Ceriani Cernadas JM, Mariani G, Pardo A, et al. [Cesarean delivery at term in low risk pregnancies: effects on neonatal morbidity]. Arch Argent Pediatr. 2010;108(1):17-23.
Ceriani Cernadas, J. M., Mariani, G., Pardo, A., Aguirre, A., Pérez, C., Brener, P., & Cores Ponte, F. A. (2010). [Cesarean delivery at term in low risk pregnancies: effects on neonatal morbidity]. Archivos Argentinos De Pediatria, 108(1), 17-23. https://doi.org/10.1590/S0325-00752010000100005
Ceriani Cernadas JM, et al. [Cesarean Delivery at Term in Low Risk Pregnancies: Effects On Neonatal Morbidity]. Arch Argent Pediatr. 2010;108(1):17-23. PubMed PMID: 20204235.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Cesarean delivery at term in low risk pregnancies: effects on neonatal morbidity]. AU - Ceriani Cernadas,José M, AU - Mariani,Gonzalo, AU - Pardo,Amorina, AU - Aguirre,Adolfo, AU - Pérez,Cecilia, AU - Brener,Pablo, AU - Cores Ponte,Florencia A, PY - 2009/07/13/received PY - 2009/09/25/accepted PY - 2010/3/6/entrez PY - 2010/3/6/pubmed PY - 2010/7/1/medline SP - 17 EP - 23 JF - Archivos argentinos de pediatria JO - Arch Argent Pediatr VL - 108 IS - 1 N2 - INTRODUCTION: The rate of cesarean delivery (CD) has significantly increased over the last years, even in low risk pregnancies. Our objective was to compare the neonatal morbidity rate in low risk term infants delivered by vaginal or CD. DESIGN: Prospective observational and analytical cohort study. Main outcome measures. Incidence of any neonatal morbidity and respiratory morbidity. Population and methods. Infants < or = 37 weeks born at the Hospital Italiano de Buenos Aires between December 2004 and July 2006 were eligible. Exclusion criteria included: any maternal related disorder, acute or chronic fetal distress, breech presentation in primiparous women, multiple pregnancies, intrauterine growth restriction and newborns with major malformations. RESULTS: A total of 2021 infants were included, 1120 born vaginally and 901 by CD. Main indications for CD were failure to progress labor (46%) and previous CD (37%). Only 3% of CD was performed by maternal request. Any neonatal morbidity rate was 9% in infants born by CD and 6.6% in infants born vaginally (RR 1.36; 95%CI 1.01-1.8). Respiratory morbidity rate was 5.3% in infants born by CD and 3.1% in those born vaginally (RR 1.7; 95%CI 1.1-2.6). When stratified by gestational age, respiratory morbidity was higher only for infants < or =38 weeks (7.4% in CD vs. 2.1% in vaginal delivery; RR 3.5; 95%CI 1.5-8.1). Also, respiratory morbidity was higher in infants born < or =38 weeks by CD without labor vs. those with labor 10.5% and 3.9%, respectively (RR 1.35; 95%CI: 1.07-1.70). In a logistic regression analysis, CD and male sex were independently associated with higher respiratory morbidity. There were not significant differences in other morbidities. NICU admission was higher in infants born by CD (9.5% vs. 6.1%; RR 1.5; 95% CI: 1.1-2.1). Sixty-eight percent of the mothers from the CD group refereed having moderate to severe pain in the puerperium vs. 36% in the vaginal group (RR 1.9; 95% CI: 1.7-2.1). Exclusive breastfeeding at discharge was significantly lower in infants born by CD (90% vs. 96%; RR 0.94 95%CI 0.92-0.96). CONCLUSIONS: Low risk CD at term was associated with a higher neonatal morbidity, NICU admission and maternal pain in the puerperium. It also reduces exclusive breastfeeding rate at discharge. SN - 1668-3501 UR - https://www.unboundmedicine.com/medline/citation/20204235/[Cesarean_delivery_at_term_in_low_risk_pregnancies:_effects_on_neonatal_morbidity]_ L2 - http://www.scielo.org.ar/scielo.php?script=sci_arttext&amp;pid=S0325-00752010000100005&amp;lng=en&amp;nrm=iso&amp;tlng=en DB - PRIME DP - Unbound Medicine ER -