EVALUATION OF THE ASSOCIATION BETWEEN GESTATIONAL AGE AND THE SEVERITY OF NEONATAL RESPIRATORY DISTRESS AMONG INFANTS DELIVERED BY CESAREAN SECTION
##plugins.themes.vojs.article.main##
Abstract
Background: The increasing rate of cesarean section is associated with a higher risk of neonatal respiratory distress (RD) due to impaired lung fluid clearance and surfactant production. This study aimed to evaluate the association between gestational age and respiratory outcomes in cesarean-delivered neonates.
Methods: A prospective cohort study was conducted on 1,078 neonates delivered by cesarean section at An Sinh Hospital. The risk of respiratory outcomes was analyzed by comparing infants born at < 39 weeks with those born at ≥ 39 weeks.
Results: The incidence of RD was 4.1%, decreasing with increasing gestational age (6.1% in late preterm vs 2.2% in ≥39 weeks). Late preterm infants had a higher risk of RD (OR = 2.89) and NICU admission (OR = 17.68). In the elective cesarean subgroup, gestational age < 39 weeks was an independent risk factor for RD (late preterm: aOR = 6.49; early term: aOR = 6.01). The need for respiratory support was significantly lower in the ≥39-week group.
Conclusions: Cesarean delivery before 39 weeks, especially without labor, increases the risk of RD and NICU admission. Elective cesarean section should be delayed until ≥ 39 weeks to improve neonatal respiratory outcomes.
##plugins.themes.vojs.article.details##
Keywords
Cesarean section, neonatal respiratory distress, early term, late preterm
References
2. Viện Kiểm soát Sức khỏe Bà mẹ và Trẻ em - Bộ Y Tế. Báo cáo tổng kết công tác chăm sóc sức khỏe bà mẹ trẻ em năm 2022.
3. Jain L, Eaton DC. Physiology of fetal lung fluid clearance and the effect of labor. Elsevier 2006;30(1):34-43. https://doi.org/10.1053/j.semperi.2006.01.006
4. Thomas J, Olukade TO, Naz A et al. The neonatal respiratory morbidity associated with early term caesarean section – an emerging pandemic. Journal of Perinatal Medicine 2021;49(7):767-772. https://doi.org/10.1515/jpm-2020-0402
5. Ma MKT, Leung KY. Timing of elective Caesarean section at term on neonatal morbidities. Hong Kong Journal of Gynaecology, Obstetrics and Midwifery 2023;23(2). https://doi.org/10.12809/hkjgom.23.2.343
6. Tsunoda Y, Shima Y, Shinmura H et al. Neonatal respiratory morbidity after late preterm, singleton, cesarean delivery before labor by mothers who did not receive antenatal corticosteroids. Journal of Nippon Medical School 2022;89(6):580-586. https://doi.org/10.1272/jnms.JNMS.2022_89-612
7. Vũ Văn Du, Lê Thị Ngọc Hương, Nguyễn Thị Hằng và cộng sự. Biến chứng của mổ lấy thai chủ động tại Bệnh Viện Phụ sản Trung ương: đánh giá trong và sau phẫu thuật. Tạp chí Y học Việt Nam 2025;555(2). https://doi.org/10.51298/vmj.v555i2.16009
8. ACOG Committee Opinion No. 761: cesarean delivery on maternal request. Obstet Gynecol 2019;133(1):e73-e77. https://doi.org/10.1097/aog.0000000000003006
9. Soltanifar S, Russell R. The National Institute for Health and Clinical Excellence (NICE) guidelines for caesarean section, 2011 update: implications for the anaesthetist. Int J Obstet Anesth 2012;21(3):264-272. https://doi.org/10.1016/j.ijoa.2012.03.004