Early C-section Births Linked to Health Risks
Cesarean births that occur too early may increase infants’ risk of future health complications, researchers warned on Wednesday.
The normal length of human gestation is 39 or 40 weeks, however doctors found that more than half of all C-section births are done by choice and one third (36 percent) are performed too early.
The American College of Obstetricians and Gynecologists (ACOG) claim that C-section operations are safe at 39 weeks, but many deliveries are being performed as early as 37 weeks.
At 38 weeks, the risk of complications increased by 50 percent, researchers reported in the New England Journal of Medicine.
Dr. Alan Tita of the University of Alabama at Birmingham led the team of researchers that studied 13,258 cases in which a woman elected to had a C-section at 37 weeks or later. Women who had medical problems or had an emergency C-section were excluded from the study.
Researchers noted that 15 percent of babies delivered at 37 weeks had a complication, compared with 8 percent of those delivered at 39 weeks.
"Even those deliveries done about three days prior to 39 weeks still have an increase in these adverse outcomes," said Dr. Tita.
Complications included respiratory problems, such as transient tachypnea, which causes infants to have trouble clearing fluid from their lungs, low blood sugar and a blood infection among others.
Doctors say previous research has shown that allowing extra time aids the development of infants’ lungs.
Women who chose to give birth early by C-section were typically white, married and privately insured, obstetric gynecologist Michael Greene of Harvard Medical School and Massachusetts General Hospital in Boston, who didn’t participate in the study, said in a commentary.
Doctors believe the research may have underestimated the risk because it was conducted at 19 academic hospitals where doctors are usually more attuned to national guidelines.
"The assumption is it may be higher if we looked at private physicians in the community," Tita said.
Tita said there is a misconception among pregnant mothers that 37 weeks amounts to a full term.
"So women, I believe, when they attain this gestational age, are tired of the pregnancy, they’re excited to see the newborn and they start asking to be delivered. So I think part of it is the pressure from the patients who want to be delivered and physicians who want to accommodate their patients,” he said.
But the study also issued a warning to doctors: don’t wait too long. The complication rate rose after 41 weeks, researchers noted.
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