The neonatal respiratory outcome in relation to timing of elective cesarean section at 38 versus 39 week gestation : a single center based study

الملخص EN

Background: Cesarean delivery per se is a risk factor of respiratory morbidity in term neonates and its timing is an adding factor of increased rates of respiratory complications.

Objective: We aimed to identify the association between elective cesarean delivery at 38 versus 39 week gestation and neonatal respiratory morbidity.

Materials and methods: We selected 200 pregnant women who underwent elective cesarean delivery at 38 or 39 week gestation at the Kasr El-Aini hospital.

Mothers were subjected to ultrasound examination.

Neonates with respiratory distress were subjected to laboratory investigations and chest X-ray.

Results: We found no association between the development of any type of respiratory distress and maternal age or parity.

The prevalence of respiratory morbidity was 25% in group A compared to 11% in group B (p= 0.01) and risk estimation showed that delivery at 38 weeks carries 2.7 time risk of having a newborn suffering from respiratory morbidity (95% CI: 1.2–5.8).

TTN was observed in 11% of group A compared to 7% of newborns of group B (p= 0.6).

RDS developed in 3 cases of group A, while none of group B developed RDS (p=0.1).

The rate of NICU admission, mechanical ventilation in the 1st 24 h and long hospital stay were insignificantly higher in group A (p>0.05).

There were no neonatal deaths in both groups.

Conclusion: Elective cesarean delivery at 39 week gestation is associated with a better neonatal respiratory outcome.

Further studies are recommended to identify the best time of elective cesarean delivery associated with the least neonatal and maternal morbidity.