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Acta Obstet Gynecol Scand. 2017 Apr;96(4):479-486. doi: 10.1111/aogs.13097. Epub 2017 Mar 9.

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

Author information

1
Perinatal Epidemiology Research Unit, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
2
Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
3
Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
4
Center of Research in Rehabilitation (CORIR), Aarhus University Hospital, Aarhus, Denmark.

Abstract

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 before labor (nonlabor 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 nonlabor CDs and 731 were labor-onset CDs. Compared to nonlabor CD, labor-onset CD was associated with similar risks of neonatal admission and respiratory distress, both at early and full term, but with a two- to three-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 postoperative antibiotic treatment and endometritis.

CONCLUSIONS:

Labor onset before planned CD was not associated with a decrease in neonatal respiratory morbidity, but may be associated with increased risks of neonatal infection.

KEYWORDS:

Cesarean; infections; labor onset; neonatology; rupture of membranes

PMID:
28100003
DOI:
10.1111/aogs.13097
[Indexed for MEDLINE]

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