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  • Original Article
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Neonatal outcomes associated with planned vaginal versus planned primary cesarean delivery

Journal of Perinatology volume 30, pages 258–264 (2010)Cite this article

Abstract

Objective:

To determine whether planned route of delivery leads to differences in neonatal morbidity.

Study Design:

Analysis was based on planned route of delivery, not actual route of delivery. A total of 4048 subjects were divided into two groups: planned vaginal delivery and planned cesarean delivery. Primary outcomes were neonatal intensive care unit (NICU) admission, respiratory morbidity and neurologic morbidity.

Result:

There were 3868 planned vaginal and 180 planned cesarean deliveries. Planned vaginal delivery had decreased NICU admission (P<0.0001), oxygen resuscitation (P=0.001) and jaundice (P<0.0001) but increased meconium passage (P<0.0001) and 1 min Apgar ⩽5 (P=0.02). After multivariable regression, NICU admission remained lower and meconium passage remained higher in the planned vaginal group.

Conclusion:

Planned vaginal delivery led to more meconium passage and low 1 min Apgar but less NICU admissions, oxygen resuscitation and jaundice. Multicenter trials are needed to assess rare but serious outcomes based on planned route of delivery.

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References

  1. Menacker F . Trends in cesarean rates for first births and repeat cesarean rates for low-risk women: United States, 1990–2003. Natl Vital Stat Rep 2005; 54 (4): 1–8.

    PubMed  Google Scholar 

  2. Hamilton BE, Martin JA, Ventura SJ . Births: preliminary data for 2006. Natl Vital Stat Rep 2007; 56 (7): 1–18.

    PubMed  Google Scholar 

  3. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S et al. Births: final data for 2005. Natl Vital Stat Rep 2007; 56 (6): 1–103.

    PubMed  Google Scholar 

  4. Visco AG, Viswanathan M, Lohr KN, Wechter ME, Gartlehner G, Wu JM et al. Cesarean delivery on maternal request: maternal and neonatal outcomes. Obstet Gynecol 2006; 108 (6): 1517–1529.

    Article  Google Scholar 

  5. NIH State-of-the-Science Conference Statement: Cesarean Delivery on Maternal Request March 27–29, 2006. Obstetr Gynecol 2006; 107 (6): 1386–1397.

    Article  Google Scholar 

  6. Zanardo V, Simbi AK, Savio V, Micaglio M, Trevisanuto D . Neonatal resuscitation by laryngeal mask airway after elective cesarean section. Fetal Diagn Ther 2004; 19 (3): 228–231.

    Article  Google Scholar 

  7. Zanardo V, Simbi AK, Franzoi M, Solda G, Salvadori A, Trevisanuto D . Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective caesarean delivery. Acta Paediatr 2004; 93 (5): 643–647.

    Article  CAS  Google Scholar 

  8. Badawi N, Kurinczuk JJ, Keogh JM, Alessandri LM, O’Sullivan F, Burton PR et al. Intrapartum risk factors for newborn encephalopathy: the Western Australian case–control study. BMJ (Clin Res Edn) 1998; 317 (7172): 1554–1558.

    Article  CAS  Google Scholar 

  9. Levine EM, Ghai V, Barton JJ, Strom CM . Mode of delivery and risk of respiratory diseases in newborns. Obstet Gynecol 2001; 97 (3): 439–442.

    CAS  PubMed  Google Scholar 

  10. Hannah ME, Hannah WJ, Hodnett ED, Chalmers B, Kung R, Willan A et al. Outcomes at 3 months after planned cesarean vs planned vaginal delivery for breech presentation at term: the international randomized Term Breech Trial. JAMA 2002; 287 (14): 1822–1831.

    Article  Google Scholar 

  11. ACOG Committee Opinion No. 386 November 2007: cesarean delivery on maternal request. Obstet Gynecol 2007; 110 (5): 1209–1212.

    Article  Google Scholar 

  12. Cohain JS, Bewley S, Hibbard JU, Gilbert S, Landon MB, Hauth JC et al. Vaginal birth after caesarean section versus elective repeat caesarean section: assess neonatal downstream outcomes too Trial of labor or repeat cesarean delivery in women with morbid obesity and previous cesarean delivery Maternal complications associated with multiple cesarean deliveries. BJOG 2006; 113 (7): 852–853; author reply 3–4.

    Article  CAS  Google Scholar 

  13. Kolas T, Saugstad OD, Daltveit AK, Nilsen ST, Oian P . Planned cesarean versus planned vaginal delivery at term: comparison of newborn infant outcomes. Am J Obstet Gynecol 2006; 195 (6): 1538–1543.

    Article  Google Scholar 

  14. Towner D, Castro MA, Eby-Wilkens E, Gilbert WM . Effect of mode of delivery in nulliparous women on neonatal intracranial injury. N Engl J Med 1999; 341 (23): 1709–1714.

    Article  CAS  Google Scholar 

  15. Irion O, Hirsbrunner Almagbaly P, Morabia A . Planned vaginal delivery versus elective caesarean section: a study of 705 singleton term breech presentations. Br J Obstet Gynaecol 1998; 105 (7): 710–717.

    Article  CAS  Google Scholar 

  16. Golfier F, Vaudoyer F, Ecochard R, Champion F, Audra P, Raudrant D . Planned vaginal delivery versus elective caesarean section in singleton term breech presentation: a study of 1116 cases. Eur J Obstet Gynecol Reprod Biol 2001; 98 (2): 186–192.

    Article  CAS  Google Scholar 

  17. Parilla BV, Dooley SL, Jansen RD, Socol ML . Iatrogenic respiratory distress syndrome following elective repeat cesarean delivery. Obstet Gynecol 1993; 81 (3): 392–395.

    CAS  PubMed  Google Scholar 

  18. Kamath BD, Todd JK, Glazner JE, Lezotte D, Lynch AM . Neonatal outcomes after elective cesarean delivery. Obstet Gynecol 2009; 113 (6): 1231–1238.

    Article  Google Scholar 

  19. Bailit JL, Love TE, Mercer B . Rising cesarean rates: are patients sicker? Am J Obstet Gynecol 2004; 191 (3): 800–803.

    Article  Google Scholar 

Download references

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Authors and Affiliations

  1. Division of Urogynecology and Reconstructive Pelvic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    E J Geller, M L Jannelli & T V Nguyen

  2. Division of Urogynecology and Reconstructive Pelvic Surgery, Duke University, Durham, NC, USA

    J M Wu & A G Visco

Authors
  1. E J Geller
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  2. J M Wu
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  3. M L Jannelli
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  4. T V Nguyen
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  5. A G Visco
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Correspondence to E J Geller.

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Geller, E., Wu, J., Jannelli, M. et al. Neonatal outcomes associated with planned vaginal versus planned primary cesarean delivery. J Perinatol 30, 258–264 (2010). https://doi.org/10.1038/jp.2009.150

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