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Postponing Elective Caesarean May Prevent Adverse Events

Early elective Caesarean delivery increases risk of adverse events over twofold

WEDNESDAY, Jan. 7 (HealthDay News) -- Adverse events that may occur following an elective Caesarean delivery at 37 weeks' gestation may be preventable if delivery is postponed to 39 weeks, according to study findings published in the Jan. 8 issue of the New England Journal of Medicine.

Alan T.N. Tita, M.D., Ph.D., of the University of Alabama at Birmingham, and colleagues conducted a cohort study of 24,077 repeat Caesarean deliveries at term from 1999 to 2002. The investigators evaluated the outcomes of elective Caesarean deliveries, occurring in women having no indication of the onset of labor, prior to 39 weeks of gestation.

Of the Caesarean deliveries performed, 13,258 were elective, the report indicates. Of these, 6.3 percent, 29.5 percent and 49.1 percent were performed at 37, 38 and 39 weeks of gestation, respectively. Compared with 39 weeks, births at 37 and 38 weeks had a 2.1-fold and 1.5-fold increased risk of resulting in adverse events, including respiratory complications, hypoglycemia, newborn sepsis, and admission to the neonatal intensive care unit, the researchers report. The investigators estimate that 48 percent and 27 percent of the adverse events that occurred following delivery at week 37 and 38, respectively, would have been preventable had delivery been postponed to 39 weeks.

"These findings support recommendations to delay elective delivery until 39 weeks of gestation and should be helpful in counseling," the authors conclude.

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