Abstract
ABSTRACTOBJECTIVETo evaluate the impact of mode of delivery on breastfeeding incentive practices and on neonatal and maternal short and long-term complications.METHODSA cohort study was conducted between June 2015 and April 2016 with 768 puerperal women from 11 maternities in Sergipe, interviewed in the first 24 hours, 45–60 days and 6–8 months after delivery. Associations between breastfeeding incentive practices, neonatal and maternal, both short-term and late complications, and the exposure variables were evaluated by the relative risk (95%CI) and the Fisher exact test.RESULTSThe C-section newborns had less skin-to-skin contact immediately after delivery (intrapartum C-section: 0.18, 95%CI 0.1–0.31 and elective C-section: 0.36, 95%CI 0.27–0.47) and less breastfeeding within one hour of birth (intrapartum C-section: 0.43, 95%CI 0.29–0.63 and elective C-section: 0.44, 95%CI 0.33–0.59). Newborns from elective C-section were less frequently breastfed in the delivery room 0.42 (95%CI 0.2–0.88) and roomed-in less 0.85 (95%CI 0.77–0.95). Women submitted to intrapartum C-section had greater risk of early complications 1.3 (95%CI 1.04–1.64, p = 0.037) and sexual dysfunction 1.68 (95%CI 1.14–2.48, p = 0.027). The frequency of neonatal complications, urinary incontinence and depression according to the mode of delivery was similar.CONCLUSIONSThe C-section was negatively associated with breastfeeding incentive practices; in addition, C-section after labor increased the risk of early maternal complications and sexual dysfunction.
Highlights
The cesarean section (C-section) is the most frequently performed surgical procedure in reproductive-aged women[1]
The C-section was negatively associated with breastfeeding incentive practices; in addition, C-section after labor increased the risk of early maternal complications and sexual dysfunction
This study aimed to evaluate the repercussions of the type of delivery on neonatal and maternal outcomes of puerperal women who attended the 11 maternities of a Northeastern Brazilian state
Summary
The cesarean section (C-section) is the most frequently performed surgical procedure in reproductive-aged women[1]. With rising C-section rates, studies have shown the dangers of this procedure to both the mother and the newborn. A prospective multicenter study with eight Latin American countries showed a higher rate of morbidity in women that opted for a C-section when compared with vaginal delivery on the following events: hysterectomy, length of hospital permanence, and use of antibiotic therapy. The neonatal mortality rate in elective C-sections with cephalic presentations decreased slightly and in those with pelvic presentation reduced significantly. C-sections were associated with a higher risk of hospitalization for over seven days in the neonatal ICU and neonatal death after discharge[4]. The C-section is associated with a higher rate of asthma, allergic rhinitis, atopy, type 1 diabetes mellitus, and celiac disease[1]
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