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Two C-Sections Aren't Better Than One While scheduling a child's birth might be appealing to parents and physicians looking for convenience, parents may want to think twice before electing for a cesarean delivery too early. A recent study at the University of Alabama Birmingham found that women choosing to have repeat cesarean deliveries before 39 weeks are twice as likely to have a baby with serious complications, including respiratory distress, oxygen ventilation or admission to the neonatal intensive care unit. 
Among the 13,258 studied women, all of which had previously elected c-sections, 35.8 percent delivered before 39 weeks. Babies born at 37 weeks were two times more likely to suffer with conditions common to babies born too soon, and at 38 weeks, were one and a half times more likely. "The cesarean rate in the United States has risen dramatically," says Alan T.N. Tita, M.D., PhD., assistant professor in the UAB Department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine and head of the research team. "Because elective cesareans can be scheduled to accommodate patient and physician convenience, there is a risk that they may be performed earlier than is appropriate." The study, conducted at 19 academic medical centers including the University of North Carolina at Chapel Hill School of Medicine, also found that babies delivered at 41 and 42 weeks faced a similarly elevated risk as those delivered before 39 weeks. "What we found is there's a very tiny window between 39 and 40 weeks where baby outcomes are optimal, and any deviation before or after that 39th week results in increased risk," says John Thorp, M.D., study co-author and division director for women's primary healthcare in the obstetrics and gynecology department at UNC. "Babies born prior to 39 weeks have more feeding difficulties, more breathing difficulties and need more medical support, whether it be artificial ventilation or oxygen support or some form of a tube feeding," Thorp says. These finding, along with other studies, highlight the importance of not delivering a baby before 39 weeks for the sake of convenience. "Unfortunately, these early deliveries are associated with a preventable increase in neonatal morbidity and NICU admissions, which carry high personal and economic costs," Tita says. "These findings support recommendations to delay elected delivery until 39 weeks gestation and should be helpful in counseling women on the necessity of waiting to deliver." |
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