Elective caesarean section at 38 weeks versus 39 weeks: neonatal and maternal outcomes in a randomised controlled trial.
BJOG
; 120(9): 1123-32, 2013 Aug.
Article
em En
| MEDLINE
| ID: mdl-23682628
ABSTRACT
OBJECTIVES:
To investigate whether elective caesarean section before 39 completed weeks of gestation increases the risk of adverse neonatal or maternal outcomes.DESIGN:
Randomised controlled multicentre open-label trial.SETTING:
Seven Danish tertiary hospitals from March 2009 to June 2011. POPULATION Women with uncomplicated pregnancies, a single fetus, and a date of delivery estimated by ultrasound scheduled for delivery by elective caesarean section.METHODS:
Perinatal outcomes after elective caesarean section scheduled at a gestational age of 38 weeks and 3 days versus 39 weeks and 3 days (in both groups ±2 days). MAIN OUTCOMEMEASURES:
The primary outcome was neonatal intensive care unit (NICU) admission within 48 hours of birth. Secondary outcomes were neonatal depression, NICU admission within 7 days, NICU length of stay, neonatal treatment, and maternal surgical or postpartum adverse events.RESULTS:
Among women scheduled for elective caesarean section at 38⺳ weeks 88/635 neonates (13.9%) were admitted to the NICU, whereas in the 39⺳ weeks group 76/637 neonates (11.9%) were admitted (relative risk [RR] 0.86, 95% confidence interval [95% CI] 0.65-1.15). Neonatal treatment with continuous oxygen for more than 1 day (RR 0.31; 95% CI 0.10-0.94) and maternal bleeding of more than 500 ml (RR 0.79; 95% CI 0.63-0.99) were less frequent in the 39 weeks group, but these findings were insignificant after adjustment for multiple comparisons. The risk of adverse neonatal or maternal outcomes, or a maternal composite outcome (RR 1.1; 95% CI 0.79-1.53) was similar in the two intervention groups.CONCLUSIONS:
This study found no significant reduction in neonatal admission rate after ECS scheduled at 39 weeks compared with 38 weeks of gestation.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Unidades de Terapia Intensiva Neonatal
/
Cesárea
/
Idade Gestacional
/
Procedimentos Cirúrgicos Eletivos
/
Depressão Pós-Parto
/
Tempo de Internação
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Newborn
/
Pregnancy
País/Região como assunto:
Europa
Idioma:
En
Revista:
BJOG
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Dinamarca