Late better than early elective term Cesarean section


E Nadir, M.D., Department of Neonatology, Hillel Yaffe Medical Center, Hadera 38100, Israel. Tel: +972-4-6304379 | Fax: +972-4-6304399 | Email:


Aim:  Caesarean section (CS) deliveries have increased, mostly because of patient/obstetrician preference. Although CS decreases the risk of delivery-related injuries, it increases the risk for respiratory and neurological complications. Complication rates are reportedly higher for elective CSs for term infants performed at 37–38 gestational weeks than later. We investigated this difference in an Israeli cohort.

Methods:  Data on all births in our medical centre during 2007–2009 were reviewed. Those on elective CSs for term infants were retrieved and divided into ‘early’ (37–38 gestational weeks) or ‘late’ (week 39 or later) groups whose epidemiological and outcome characteristics were compared.

Result:  Of the 12 276 births, 596 were early and 454 were late elective CSs. There were no differences in gender, ethnicity, Apgar score or length of hospital stay. Twenty-six infants from the early group and 11 infants from the late group were transferred to the neonatal intensive care unit. Within them, compared with all elective CSs, the morbidity rate was higher for the former infants than for the latter.

Conclusion:  Morbidity was higher among infants who were delivered at 37–38 gestational weeks by elective CS. We recommend postponing elective CSs to ≥39 weeks.