Background and Goal of Study: Early term cesarean delivery (CD) increases the risk of neonatal respiratory morbidity,
however planning a later term CD could result in spontaneous onset of labor requiring urgent CD. (1,2) We aimed to
assess maternal and neonatal morbidity including need for general anesthesia and hemorrhage for early versus later term
planned CD.
Materials and methods: Retrospective cohort with IRB approval included women who booked and planned CD in a single
tertiary medical center (20122015).
Early term planned CD (n = 370, 37+0to38+6wks) was compared for maternal and
neonatal morbidities versus later term planned CD (n=300, 39+0 to 40+6wks) using descriptive statistics, p< 0.05 is
significant.
Results and discussion: The early term CD group comprised older, multiparous women with more prior CD, Table 1.
Respiratory morbidity was higher among neonates born at early (2.7%) versus later term (0.3%) p=0.03. The risk of
spontaneous onset of labor/rupture of membranes, outofhours
delivery and urgent CD were significantly higher for the
later term group. We found no significant difference in maternal morbidity (anesthesia complications, anesthesia mode,
hemorrhage, surgical complications) between the groups, Table 2.
Conclusion(s): Early term CD was associated with increased neonatal respiratory morbidity. Waiting for late term to
perform CD significantly increases risk of urgent and out of hours CD, however did not increase anesthesia, hemorrhage
and other measures of maternal morbidity in our population.
References: 1. Hansen AK etal. BMJ 2008; 336:857
2. Chiossi G etal. Obstet Gynecol 2013; 121:5619

Retrospective cohort study to assess the impact of early versus later term planned cesarean delivery on maternal and neonatal outcomes