The neonatal respiratory outcome in relation to timing of elective cesarean section at 38 versus 39 week gestation: A single center based study

Abstract

BackgroundCesarean delivery per se is a risk factor of respiratory morbidity in term neonates and its timing is an adding factor of increased rates of respiratory complications. ObjectiveWe aimed to identify the association between elective cesarean delivery at 38 versus 39week gestation and neonatal respiratory morbidity. Materials and methodsWe selected 200 pregnant women who underwent elective cesarean delivery at 38 or 39week gestation at the Kasr El-Aini hospital. Mothers were subjected to ultrasound examination. Neonates with respiratory distress were subjected to laboratory investigations and chest X-ray. ResultsWe found no association between the development of any type of respiratory distress and maternal age or parity. The prevalence of respiratory morbidity was 25% in group A compared to 11% in group B (p=0.01) and risk estimation showed that delivery at 38weeks carries 2.7 time risk of having a newborn suffering from respiratory morbidity (95% CI: 1.2–5.8). TTN was observed in 11% of group A compared to 7% of newborns of group B (p=0.6). RDS developed in 3 cases of group A, while none of group B developed RDS (p=0.1). The rate of NICU admission, mechanical ventilation in the 1st 24h and long hospital stay were insignificantly higher in group A (p>0.05). There were no neonatal deaths in both groups. ConclusionElective cesarean delivery at 39week gestation is associated with a better neonatal respiratory outcome. Further studies are recommended to identify the best time of elective cesarean delivery associated with the least neonatal and maternal morbidity.