FYI
Elective Repeat C-Section May Negatively Affect Neonatal OutcomesNEW YORK (Reuters Health) Jun 09 - Compared with intending to deliver vaginally, undergoing a scheduled repeat cesarean delivery apparently raises the risk that the newborn will be admitted to an advanced care nursery, according to a brief report. The researchers say women should be alerted to the possible negative effects.
The study, in the May issue of the American Journal of Obstetrics and Gynecology, is the first to directly compare the neonatal outcomes of elective c-section with those of a trial of labor in uncomplicated pregnancies, note Dr. Nicholas Fogelson and colleagues, from the Medical University of South Carolina in Charleston.
In a retrospective cohort analysis, the investigators assessed the neonatal outcomes of 3134 mothers intending to deliver vaginally and 117 mothers who underwent elective repeat cesarean section.
In the overall analysis, the risk ratio for admission to an advanced care nursery was 3.58 for infants in the elective c-section group compared to those from the intended vaginal group (p < 0.001). Transient tachypnea was also more common in the elective cesarean group (p = 0.0009).
When the analysis was confined to mothers who underwent unscheduled c-section after a trial of labor, the advanced care nursery finding was no longer statistically significant. Also, infants born to such mothers were more likely to have lower APGAR scores than those in the elective c-section group.
"The decision to undergo elective cesarean delivery appears to have a negative impact on immediate neonatal outcomes," the authors state. They advise that for women considering a scheduled cesarean delivery, "physicians should counsel patients about potential neonatal issues in addition to concern for maternal well-being."
Am J Obstet Gynecol 2005;192:1433-1436. Leanne Wynne Midwife in charge of "Women's Business" Mildura Aboriginal Health Service Mob 0418 371862 -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
