ABSTRACT 474

Abstract

Background and aims: Respiratory morbidity is an important complication of ECS in term infants. The incidence of respiratory distress was reported in 6% of newborns delivered by ECS, 5 versus 1% in Infants born vaginally. Aims: Our objective was to find out the incidence of respiratory distress in term neonates delivered by elective cesarean section and compare it with neonates delivered vaginally. Methods: Cohort study with prospectively collected data of all the deliveries on mothers with gestational ages between 37 and 40 weeks that were performed in our Hospital from 1 January 2011 to 1 December 2013. Primary outcome measures of neonatal respiratory morbidity included transient tachypnoea of newborn, respiratory distress syndrome, persistent pulmonary hypertension of newborn, serious respiratory morbidity (oxygen therapy for more than two days, nasal continuous positive airway pressure, or need for mechanical ventilation). Results: Compared with newborns intended for vaginal delivery, an increased risk of respiratory morbidity was found for infants delivered by elective caesarean section at 37 +0 weeks’ gestation to 37+6 weeks (odds ratio 3.8, 95% confidence interval 2.4 to 6.5), 38+0 weeks’ gestation to 38+6 weeks (3.0, 2.1 to 4.3), and 39+0 weeks’ gestation (1.9, 1.2 to 3.0). and had higher rates of oxygen supplementation for delivery room resuscitation (41.5%). Conclusions: The odd ratio for neonatal respiratory distress was 3.8, almost fourthfold higher in cesarean section group than those delivered vaginally. When considering elective Caesarean section before 39 weeks of gestation, obstetricians should carefully balance these risks and if feasible avoid the procedure.