Latin American Study Details C-Section Risks, Benefits

Mothers face higher morbidity risks; procedure protects against fetal death in breech position

WEDNESDAY, Oct. 31 (HealthDay News) -- Women who have a Caesarean delivery face at least double the risk of a serious event including maternal death or severe morbidity compared to women having a vaginal delivery, according to research published Oct. 30 in BMJ Online First.

Jose Villar, M.D., of the University of Oxford in the United Kingdom, and colleagues analyzed data from 97,095 deliveries in 120 medical facilities in eight randomly selected Latin American countries. Of these, 33.7 percent were Caesarean deliveries, and 66.3 were vaginal deliveries.

The researchers found that women having a Caesarean delivery had an increased risk of an event included in an index of mortality or severe maternal morbidity if the procedure was intrapartum (odds ratio 2.0) or elective (OR, 2.3), and women had a five times higher risk of needing antibiotic treatment after Caesarean, compared to vaginal delivery. The surgical procedure offered a protective effect against fetal death during breech presentations, but for cephalic presentations, either type of Caesarean raised the risk of neonatal mortality up to discharge (OR, 1.7 for intrapartum, 1.9 for elective).

"We conclude that any net benefit from the liberal use of Caesarean delivery on maternal and neonatal outcomes, at the institutional or individual level, remains to be demonstrated, with the exception of fewer severe vaginal complications after delivery and better fetal outcomes among breech presentations," the authors write.

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