Tine Brink Henriksen

Neonatal morbidity after spontaneous labor onset prior to intended cesarean delivery at term: a cohort study

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INTRODUCTION: We aimed to investigate if labor onset before planned cesarean delivery (CD) affects the risk of neonatal admission, respiratory distress, or neonatal infectious morbidity.

MATERIAL AND METHODS: Our cohort included singleton term pregnant women with intended CD who delivered at Aarhus University Hospital from 1990 to 2012. Two groups of women were identified: Women with intended CD performed prior to labor (non-labor CD) and women with intended CD performed after spontaneous labor onset (labor onset CD); in both groups there was no other maternal or fetal medical indication for an immediate CD or for early term CD scheduling. Data were stratified in early term (37-38 weeks) and full term (39-40 weeks) deliveries. The main outcome measures were neonatal admission, respiratory distress, and neonatal infectious morbidity.

RESULTS: Among 103 919 live births, 5071 deliveries were non-labor CDs and 731 were labor onset CDs. Compared to non-labor CD, labor onset CD was associated with similar risks of neonatal admission and respiratory distress, both at early and full term, but with a 2-3 fold increased risk of newborn septicemia or antibiotic treatment at early term. Labor onset at early term was associated with a lower risk of maternal blood loss of more than 500 ml, but with a higher risk of post-operative antibiotic treatment and endometritis.

CONCLUSIONS: Labor onset prior to planned CD was not associated with a decrease in neonatal respiratory morbidity, but may be associated with increased risks of neonatal infection. This article is protected by copyright. All rights reserved.

TidsskriftActa Obstetrica et Gynecologica
StatusUdgivet - 2017

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