Could elective cesarean sections influence the birth weight of full-term infants?

Eddie Fernando Candido Murta,Guilherme Carvalho Freire,Renato Humberto Fabri,Daniel Capucci Fabri

doi:10.1590/s1516-31802006000600002

Eddie Fernando Candido Murta, Guilherme Carvalho Freire + Show 2 more

Open Access

https://doi.org/10.1590/s1516-31802006000600002

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Abstract

There are no studies on birth weights among full-term infants born by means of elective cesarean section. We aimed to study this in private and public hospitals. Retrospective study at Universidade Federal do Triângulo Mineiro, Uberaba, Brazil. Data were collected from the municipal medical birth register of Uberaba from January to December 2000. The data obtained (maternal age, type of delivery, number of prenatal care visits and birth weight, from full-term pregnancy) from the university hospital (UH), which is a tertiary hospital that only attends patients within the National Health System (SUS), were compared with data from four private hospitals (PHs) that attend health insurance plans and private patients. Student's t test, chi2 test and multiple logistic regression were used for statistical analysis, with the significance level set at p < 0.05. In the PHs, 1,100 out of 1,354 births (81.2%) were by cesarean section and in the UH, 373 out of 1,332 (28%). Birth weight increased significantly in association with increasing numbers of prenatal care visits, except for cesarean section cases in PHs. Birth weights among vaginal delivery cases in PHs were greater than in the UH (p < 0.05), but this was not observed among cesarean section cases. Multiple logistic regression showed that there was greater risk of low birth weight in PHs (odds ratio: 2.33; 95% confidence interval: 1.19 to 4.55). Elective cesarean section performed in PHs may be associated with low birth weight among full-term infants.

Highlights

Increasing cesarean section rates are a worldwide phenomenon, especially in Brazil, but they still cannot be fully explained.[1,2,3] The culture of cesareans in Brazil affects obstetricians and society in general.[3]
Birth weights among vaginal delivery cases in private hospitals (PHs) were greater than in the university hospital (UH) (p < 0.05), but this was not observed among cesarean section cases
We had expected that the birth weights among vaginal delivery and cesarean section cases would be significantly higher in the PHs than in the HU, but this occurred only among the vaginal delivery cases

Summary

Introduction

Increasing cesarean section rates are a worldwide phenomenon, especially in Brazil, but they still cannot be fully explained.[1,2,3] The culture of cesareans in Brazil affects obstetricians and society in general.[3]. Neonatal respiratory distress risks may be a complication in elective cesarean sections.[6] In Brazil, some studies have showed increased rates of preterm births and low birth weight (< 2500 g), probably due to iatrogenic practices related to elective cesarean sections.[7,8] But to our knowledge, there have not been any studies on birth weights of full term infants born by means of elective cesarean section. Infants born from elective cesarean section at a gestational age of 37 weeks will have lower birth weight than if they were born at a gestational age of 40 weeks

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