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KMID : 0361720130240040290
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Korean Journal of perinatology
2013 Volume.24 No. 4 p.290 ~ p.299
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Respiratory Morbidities in Newborn Infants by Gestational Age Following Elective Cesarean Section beyond 35 Weeks of Gestation
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Hwang Jin-Sol
Kim Sae-Yun
Shin Seung-Han
Lee Ju-Young
Kim Ee-Kyung
Kim Han-Suk
Choi Jung-Hwan
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Abstract
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Purpose: We evaluate respiratory morbidities in infants beyond 35 weeks of gestation born via elective cesarean section by gestational age.
Methods: This is a retrospective study of 443 infants who were born at Seoul National University Hospital by elective cesarean section beyond 35 weeks of gestation from January 2011 to December 2012. We compared respiratory morbidities in four groups classified by gestational age (35+0-36+6 weeks, 37+0-37+6 weeks, 38+0-38+6weeks, 39+0-40+6 weeks).
Results : There were significantly lower Apgar scores in the late-preterm infant group (35-36 weeks) compared to other term infant groups and the proportion of infants born from mothers with preeclampsia gradually decreased as gestational age increased. There were significant differences in O2 supplement, duration of O2 (>24hours), checked chest radiography, transient tachypnea of newborn (TTN), transfer to neonatal intensive careunit (NICU), end otracheal intubation, and ventilator uses including nasal continuous positive airway pressurein four groups (P <0.05). By logistic regression analysis, compared to births at 38 weeks, births at 35-36 weeks and at 37 weeks were associated with an increased risk of respiratory morbidities [odds ratios (OR) and 95%confidence intervals (CI) for births at 35-36 weeks, 122.5 (17.4-863.4) for TTN; 54.0 (10.1-289.4) for transfer to NICU; 99.5 (14.9-666.2) for ventilator apply; OR and 95% CI for births at 37 weeks, 8.8 (1.6-50.1) for TTN;5.3 (1.1-24.7) for transfer to NICU; 8.4 (1.5-47.7) for ventilator apply; P <0.05]. There were no significant differences in respiratory morbidities between births at 38 weeks and births at 39-40 weeks.
Conclusion: Postponing the timing of elective cesarean section to beyond 38 weeks of gestation would be helpful in reducing the neonatal respiratory morbidities.
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KEYWORD
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Respiration disorders, Cesarean section, Term birth, Late preterm, Gestational age
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