Neonatal Respiratory Morbidity After Elective Caesarean Section At Term
Keywords:
Cesarean section, infant newborn, respiratory morbidityAbstract
Background : Incidence of elective caesareans at term is increasing these last decades with an associated increase of neonatal respiratory morbidity.
Aim: To analyse the influence of elective Caesarean delivery at term on the incidence of neonatal respiratory distress in order to propose an effective strategy of prevention.
Methods: It is an analytical study compiling all births resulting from elective Caesarean at term (gestationnel age ranging between 37 and 41+6 GA), reported over two years period at the Charles Nicolle hospital (Tunis-Tunisia). We compared 250 live births, without maternel risk factors, delivered by elective Caesarean to 250 births delivered by vaginal way.
Results: Frequency of the elective Caesarean at term was of 3.6% live births; it was mainly indicated in the presence of a cicatricial uterus. The incidence of respiratory morbidity was 6% (15/250) in the group exposed to the elective caesarean versus 1.6% (4/250cas) in the citationsRaw group, OR = 3.9; 95%CI: [1, 28-11, 99] p<0.01. Before the term of 39 GA, OR = 5.22; 95%CI: [1.14-23.87] p=0.01.
After 39 GA, the risk of respiratory distress decreased: OR = 1.86 95%CI: [0.30, 11.35] NS. The principal etiology of respiratory distress in the exposed group was the transitory tachypnea of the newborn.
Conclusion: Incidence of respiratory distress was higher at newborn babies born from elective Caesarean with a significant reduction in this incidence after the term of 39 GA.
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