Elective caesarean section at 38 versus 39 weeks of gestation: neonatal and maternal outcomes in a randomised controlled trial
Article first published online: 11 NOV 2013
© 2013 Royal College of Obstetricians and Gynaecologists
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 120, Issue 13, page 1703, December 2013
How to Cite
Sanu, O. (2013), Elective caesarean section at 38 versus 39 weeks of gestation: neonatal and maternal outcomes in a randomised controlled trial. BJOG: An International Journal of Obstetrics & Gynaecology, 120: 1703. doi: 10.1111/1471-0528.12469
- Issue published online: 11 NOV 2013
- Article first published online: 11 NOV 2013
- Manuscript Accepted: 22 JUL 2013
I read with interest the randomised controlled trial (RCT) of elective caesarean section at 38 versus 39 weeks of gestation in singleton pregnancies.
The authors' observation that the admission rate to the neonatal intensive care unit (NICU) at 38+3 weeks of gestation following elective caesarean section was similar to that at 39 weeks of gestation was based on the defined outcomes mentioned in their methodology. Although their observation, with respect to the NICU admission rate, has been reported before, other adverse neonatal outcomes (not included in their study outcomes, and that may not require NICU admission) have been investigated and found to be significantly reduced when elective caesarean section was performed at 39–40 weeks of gestation, compared with 38 weeks of gestation.[3, 4] These adverse outcomes, including an increased neonatal mortality rate and rate of hospitalisation for 5 days or longer, have implications for parents and clinicians, and can be avoided.
Considering all possible neonatal adverse outcomes, the timing of elective caesarean section without medical indication at ≥39 weeks of gestation may be preferred to 38+3 weeks of gestation until proven otherwise.