Infant outcome worse with planned c-section
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Newborns who are delivered via planned cesarean section are more likely to be transferred to the neonatal intensive care unit and to experience lung disorders compared with those delivered via planned vaginal delivery, according to findings published in the American Journal of Obstetrics and Gynecology.
“The appropriateness of the rising rate of cesarean delivery worldwide has been debated widely,” Dr. Toril Kolas, of Innlandet Hospital Trust, Lillehammer, Norway, and colleagues write.
The researchers examined the outcome of deliveries during a 6-month period, along with data from the Medical Birth Registry of Norway on intended mode of delivery.
Of the 18,653 deliveries, 17,828 were planned vaginal deliveries and 825 were planned cesarean deliveries.
Rates of transfer to the neonatal intensive care unit were 5.2 percent for planned vaginal deliveries, significantly lower than the 9.8 percent for planned cesarean deliveries. Lung disorders were also significantly lower in the planned vaginal delivery group (0.8 percent) than in the cesarean delivery group (1.6 percent).
No significant differences were observed in the risks of low Apgar score or neurological symptoms.
“For the child, the stress of vaginal delivery seems superior to elective cesarean delivery in many situations,” Kolas and colleagues conclude. “Therefore, we emphasize the importance of limiting planned cesarean deliveries to cases with proven benefit for the mother and/or child,” they write. “When a planned cesarean delivery is chosen, the operation should be as close to term as possible.”
SOURCE: American Journal of Obstetrics and Gynecology, December 2006.
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