Wednesday, January 7, 2009

Breathing difficulties are worse PRIOR TO 39 weeks gestation

This new study from Norway is a perfect example of how the risks associated with cesarean delivery are not necessarily relevant in a comparison of risks and benefits between planned vaginal delivery and planned cesarean delivery in healthy pregnancies with no medical indication in countries that follow the medical guidelines of waiting until 39 confirmed gestational weeks before performing surgery.

In Torkil et al's study, 'Cesarean section is associated with more frequent pneumothorax and respiratory problems in the neonate', the authors demonstrate that among 5,957 cesarean deliveries (20.3% of all 29,358 deliveries) between 2001 and 2005, "among the 26,664 neonates born at term (≥37th gestational week), 4,546 were delivered by CS (17.0%), of whom 0.5% by elective and 0.6% by emergency CS with NP [neonatal pneumothorax]. The incidence of diagnosed NP was significantly higher after CS than after vaginal delivery [0.6% vs. 0.10%]... In addition, the need for MV [mechanical ventilation] was significantly increased [0.41% vs. 0.19%] but use of CPAP [Continuous Positive Airways Pressure] was not [0.28%vs. 0.15%]."

This simply confirms recommendations by ACOG and the NIH (among others) to wait until confirmed 39 weeks getstaional age before scheduling planned cesarean deliveries. The respiratory outcomes for babies at 39 weeks are greatly improved and therefore this study should not be used as an argument against cesarean delivery on maternal request in healthy pregnancies.

1 comment:

Morgan said...

And then, unfortunately, some babies still go into respiratory distress at 39+ weeks due to not having all the fluid squeezed out during birth. Or perhaps due to taking a big gulp while being lifted out.

As a mom who has had 4 c-sections, including 1 baby who went through a serious case of respiratory distress at birth, I would never recommend a c-section that isn't medically necessary.