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Neonatal morbidity and mortality for repeated cesarean section vs. normal vaginal delivery to uncomplicated term pregnancies at Srinagarind Hospital.
J Med Assoc Thai. 2013 Jun; 96(6):654-60.JM

Abstract

OBJECTIVE

To evaluate the morbidities and mortality of neonates delivered by elective repeated cesarean section vs. normal vaginal delivery among women with uncomplicated term pregnancies.

MATERIAL AND METHOD

A retrospective descriptive study was done between January 2009 and December 2011 to determine the morbidities and mortality among uncomplicated term pregnancies at Srinagarind Hospital. Three hundred seventy two neonates delivered by elective repeated cesarean section vs. 1,581 by normal vaginal delivery.

RESULTS

A significantly greater number of neonates in the elective repeated cesarean section group required oxygen for neonatal resuscitation compared to neonates in the normal vaginal delivery group (37.6% vs. 20.9%, p < 0.001). Neonates delivered by elective repeated cesarean section were more frequently admitted to the neonatal intensive care unit (1.1% vs. 0%, p < 0.001) and had longer hospital stays (4.56 +/- 2.45 vs. 4.07 +/- 1.44 days, p < 0.001). The latter not only had a higher rate of respiratory distress syndrome (0.8% vs. 0%, p < 0.001) and transient tachypnea of the newborn (3.2% vs. 0.3%, p < 0.001), which required more respiratory support, they also had a higher rate of infection (2.4% vs. 0.8%, p < 0.05) than neonates delivered by normal vaginal delivery. Neonates born by normal vaginal delivery, however had more birth trauma and hyperbilirubinemia than neonates born by elective repeated cesarean section (8.8% vs. 2.4%, p < 0.001 and 31.8% vs. 22.6%, p < 0.05, respectively). There was no difference in the mortality rate between the groups.

CONCLUSION

Even among uncomplicated term pregnancies, cesarean section is associated with more neonatal respiratory morbidity and sepsis while those delivered by normal vaginal delivery tend to have a higher rate of birth trauma and hyperbilirubinemia. Clinicians should therefore be concerned about the route of delivery and the probability of negative neonatal outcomes.

Authors+Show Affiliations

Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23951821

Citation

Wankaew, Nootwadee, et al. "Neonatal Morbidity and Mortality for Repeated Cesarean Section Vs. Normal Vaginal Delivery to Uncomplicated Term Pregnancies at Srinagarind Hospital." Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, vol. 96, no. 6, 2013, pp. 654-60.
Wankaew N, Jirapradittha J, Kiatchoosakun P. Neonatal morbidity and mortality for repeated cesarean section vs. normal vaginal delivery to uncomplicated term pregnancies at Srinagarind Hospital. J Med Assoc Thai. 2013;96(6):654-60.
Wankaew, N., Jirapradittha, J., & Kiatchoosakun, P. (2013). Neonatal morbidity and mortality for repeated cesarean section vs. normal vaginal delivery to uncomplicated term pregnancies at Srinagarind Hospital. Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, 96(6), 654-60.
Wankaew N, Jirapradittha J, Kiatchoosakun P. Neonatal Morbidity and Mortality for Repeated Cesarean Section Vs. Normal Vaginal Delivery to Uncomplicated Term Pregnancies at Srinagarind Hospital. J Med Assoc Thai. 2013;96(6):654-60. PubMed PMID: 23951821.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neonatal morbidity and mortality for repeated cesarean section vs. normal vaginal delivery to uncomplicated term pregnancies at Srinagarind Hospital. AU - Wankaew,Nootwadee, AU - Jirapradittha,Junya, AU - Kiatchoosakun,Pakaphan, PY - 2013/8/20/entrez PY - 2013/8/21/pubmed PY - 2013/9/21/medline SP - 654 EP - 60 JF - Journal of the Medical Association of Thailand = Chotmaihet thangphaet JO - J Med Assoc Thai VL - 96 IS - 6 N2 - OBJECTIVE: To evaluate the morbidities and mortality of neonates delivered by elective repeated cesarean section vs. normal vaginal delivery among women with uncomplicated term pregnancies. MATERIAL AND METHOD: A retrospective descriptive study was done between January 2009 and December 2011 to determine the morbidities and mortality among uncomplicated term pregnancies at Srinagarind Hospital. Three hundred seventy two neonates delivered by elective repeated cesarean section vs. 1,581 by normal vaginal delivery. RESULTS: A significantly greater number of neonates in the elective repeated cesarean section group required oxygen for neonatal resuscitation compared to neonates in the normal vaginal delivery group (37.6% vs. 20.9%, p < 0.001). Neonates delivered by elective repeated cesarean section were more frequently admitted to the neonatal intensive care unit (1.1% vs. 0%, p < 0.001) and had longer hospital stays (4.56 +/- 2.45 vs. 4.07 +/- 1.44 days, p < 0.001). The latter not only had a higher rate of respiratory distress syndrome (0.8% vs. 0%, p < 0.001) and transient tachypnea of the newborn (3.2% vs. 0.3%, p < 0.001), which required more respiratory support, they also had a higher rate of infection (2.4% vs. 0.8%, p < 0.05) than neonates delivered by normal vaginal delivery. Neonates born by normal vaginal delivery, however had more birth trauma and hyperbilirubinemia than neonates born by elective repeated cesarean section (8.8% vs. 2.4%, p < 0.001 and 31.8% vs. 22.6%, p < 0.05, respectively). There was no difference in the mortality rate between the groups. CONCLUSION: Even among uncomplicated term pregnancies, cesarean section is associated with more neonatal respiratory morbidity and sepsis while those delivered by normal vaginal delivery tend to have a higher rate of birth trauma and hyperbilirubinemia. Clinicians should therefore be concerned about the route of delivery and the probability of negative neonatal outcomes. SN - 0125-2208 UR - https://www.unboundmedicine.com/medline/citation/23951821/Neonatal_morbidity_and_mortality_for_repeated_cesarean_section_vs__normal_vaginal_delivery_to_uncomplicated_term_pregnancies_at_Srinagarind_Hospital_ L2 - https://medlineplus.gov/commoninfantandnewbornproblems.html DB - PRIME DP - Unbound Medicine ER -