Evaluation of neonatal outcomes in elective repeat cesarean delivery at term according to weeks of gestation


Dr İsmet Gün, Department of Obstetrics and Gynecology, GATA Haydarpasa Training Hospital, İstanbul 34668, Turkey. Email: drismetgun@gmail.com; drsmetgun@yahoo.com


Aim:  Our aim is to evaluate the association between gestational age at delivery and neonatal outcomes in elective cesarean delivery.

Material and Methods:  A total of 1784 viable singleton pregnancies that were delivered by elective caesarean section at term were included in the study. All pregnancies were categorized according to the number of completed weeks of gestation (37+0–6, 38+0–6, 39+0–6 and ≥40+0 weeks). In this study, the patient groups compared in terms of demographic characteristics and neonatal outcomes.

Results:  The rates of the neonatal intensive care unit admission were 8.7%. When maternal and neonatal characteristics were statistically analyzed, the incidence of advanced maternal age and previous cesarean delivery increased as gestational age at delivery decreased; the incidence of nuchal cord and delivering a baby of ≥4000 g at birth increased as gestational age at delivery increased. As compared with deliveries at 39 weeks, cesarean delivery at 37 weeks of gestation had significantly higher risk, including that of neonatal intensive care unit admission, transient tachypnea of the newborn after delivery and O2 support. There was one perinatal death observed in the study.

Conclusions:  According to the results of our study, compared to elective cesarean delivery after 37 weeks of gestation, elective cesarean delivery at 37 weeks of gestation was associated with a statistically significant increase in neonatal mortality. Therefore, elective cesarean delivery should not be performed at 37 weeks of gestation and 39 weeks of gestation appears to be the ideal timing for elective cesarean delivery.