January 12, 2009

Timing of Cesarean Delivery Critical

Research shows that repeat elective cesarean delivery performed before 39 weeks of gestation can have adverse effects on a baby's fetal lung development.

The rate of cesarean delivery in the United States has increased dramatically, from 20.7 percent in 1996 to 31.1 percent in 2006; but cesarean delivery does not come risk-free. Infants born before 39 weeks of gestation can suffer from death, respiratory distress syndrome, newborn sepsis and seizures.

A study of nearly 25,000 cesarean deliveries revealed that when compared with the births at 39 weeks, births at 37 and 38 weeks experienced increased risks.

"As compared with infants born vaginally, those born by cesarean section are at increased risk for adverse respiratory outcomes, especially when the delivery occurs before the onset of labor," study authors noted.

Experts say it is common for women to undergo cesarean deliveries before the baby has reached the appropriate gestational age because of their desire to give birth and because of obstetricians' desires to schedule the procedure at a convenient time; however, delaying the procedure until 39 weeks of gestation decreases neonatal morbidity.

Study authors also found, however, that delaying delivery beyond 40 weeks is linked to increased rates of adverse outcomes. Testing for fetal lung maturity can help determine whether the time is appropriate.

Source: New England Journal of Medicine, January 8, 2009


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