Does an increased cesarean section rate improve neonatal outcome in term pregnancies?

Kupari, Marja; Talola, Nina; Luukkaala, Tiina; Tihtonen, Kati

doi:10.1007/s00404-015-3942-4

Cited by 26 publications

(24 citation statements)

References 16 publications

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“…Vaginal delivery and vacuum-assistance were the only significant risk factors for intracranial hemorrhages, from a number of obstetric variables evaluated in our study. In Finland, the rate of c-sections almost doubled between the years 1998 and 2005, from 6.8 to 11.3% (27), with the latest rate of 15.9% for sections (6.7% for emergency sections) (24), and a similar trend in the popularity of c-sections can be seen worldwide (28). The current reasoning behind selecting c-section as the delivery method more frequently is to ensure the safety of the neonate.…”

Section: Discussionmentioning

confidence: 90%

“…The current reasoning behind selecting c-section as the delivery method more frequently is to ensure the safety of the neonate. However, this has not lead to improvements in neonatal outcomes in the short term, but instead has increased admissions to neonatal intensive care units (NICUs) (27). Cesarean sections are known to predispose neonates to respiratory distress and tachypnea (29).…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and Risk Factors of Incidental Findings in Brain MRIs of Healthy Neonates—The FinnBrain Birth Cohort Study

et al. 2020

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Background: Birth is a traumatic event with molding forces directed to the fetal skull, which may result in intracranial hemorrhages. However, the knowledge on prevalence and risk factors of incidental brain magnetic resonance imaging (MRI) findings in infants is still inconclusive. Methods: The prevalence and nature of incidental MRI findings were assessed in a birth cohort of 175 asymptomatic infants. The role of delivery method as well as other potential risk factors for intracranial hemorrhages were evaluated. The infants underwent 3T MRI at the age of 2-5 weeks, and the neurological status of the infants with an incidental finding was evaluated by a pediatric neurologist. Information on the delivery method, duration of delivery, parity, used anesthesia, oxytocin induction, and Apgar score was gathered to evaluate their association with the prevalence of hemorrhages. Results: Incidental intracranial hemorrhages were detected in 12 infants (6.9%), all following spontaneous or assisted vaginal delivery. Vacuum-assistance was found to be a risk factor for subdural hemorrhages with an odds ratio (OR) of 4.7 (95% CI [1.18; 18.9], p = 0.032). All infants were evaluated to develop normally by their clinical status. Conclusions: Incidental intracranial hemorrhages are relatively common among infants born by vaginal delivery. They are often of little clinical significance within the first years of life and have unlikely consequences for later neurodevelopment either. Despite their benign character, investigators should be prepared to share this information with parents competently as the findings can cause parental anxiety, and especially as the popularity of MRI as a research tool is increasing.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factors of Incidental Findings in Brain MRIs of Healthy Neonates—The FinnBrain Birth Cohort Study

et al. 2020

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“…Globally, cesarean section (CS) rates have increased during the last decades [1] resulting in an overall CS rate close to 26 % in 2010 [2]. CS rates differ substantially in different parts of the world, ranging from approximately 1 % in some African countries (South Sudan and Niger) to 56 % in some American countries (Brazil and the Dominican Republic) [3].…”

Section: Introductionmentioning

confidence: 99%

Indications for Cesarean Sections in Rural Nepal

Samdal

Steinsvik

Pun³

et al. 2016

J Obstet Gynecol India

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Objective Globally, cesarean section (CS) rate is close to 26 %. Nepal has a reported CS rate of 5 %, with huge differences in rural (3.5 %) and urban (15 %) areas. The aim of the study was to determine the rate and indications for CS in a remote hospital in a rural area of Nepal. Methods A one-year cross-sectional prospective study from August 2014 to August 2015 was performed at Okhaldhunga Community Hospital (OCH). Semi-structured interviews of all women undergoing CS (91) were done, partly with the assistance of a local translator. A maternal waiting home is connected to the hospital. Results Out of the 864 births in the hospital, 91 CS were performed giving a CS rate of 9.5 %. The most frequent indications were: prolonged labor in 24 CS (26.4 %), abnormal fetal lie in 23 CS (25.3 %) and fetal distress in 18 CS (19.8 %). Three-quarters of CS were performed as an Live Johanne Samdal is a medical student at Oslo University in Norway. She is currently in her sixth and last year of medical school. Live has a special interest in international health issues, children and maternal health. This article is a part of her mandatory student thesis which included the five-week field work in Nepal.

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“…This supports the argument that a rise in the CS rate is likely to improve pregnancy outcomes. However, in developed countries, a sharp increase in CS rate has not been shown to improve pregnancy outcomes and could be associated with increased adverse maternal complications [7][8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

20-year trend in Caesarean section rates in primiparous women in a regional obstetric unit in Hong Kong

2019

Hong Kong J Gynaecol Obstet Midwifery

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Introduction: Using the Robson classification, we analysed the 20-year trend of Caesarean section (CS) rates among primiparous women in a regional obstetric unit in Hong Kong. Methods: Deliveries over a 20-year period (1997-2016) from United Christian Hospital were classified into one of 10 categories according to the Robson classification. The annual CS rate was calculated for each category, and data were stratified into four 5-year intervals to determine any trends. Results: A total of 86 908 deliveries from 1997 to 2016 were included for analysis. The overall CS rate increased from 17.5% to 23.5% over the period. However, the overall primiparous CS rate only increased modestly from 20.8% to 22.8%, with main contributors being breech presentation (category 6), multiple pregnancies (category 8), and preterm labour (category 10). Contrarily, the CS rate declined mildly among those with spontaneous and induced labour (category 1 and 2). These trends were significant (p<0.001) after stratification into four 5-year intervals. Conclusion: Despite a sharper rise in overall CS rate over the past 20 years, the CS rates in primiparous women increased modestly, mainly because of modest increases in rates of breech presentation, multiple pregnancies, and preterm labour.

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Does an increased cesarean section rate improve neonatal outcome in term pregnancies?

Cited by 26 publications

References 16 publications

Prevalence and Risk Factors of Incidental Findings in Brain MRIs of Healthy Neonates—The FinnBrain Birth Cohort Study

Prevalence and Risk Factors of Incidental Findings in Brain MRIs of Healthy Neonates—The FinnBrain Birth Cohort Study

Indications for Cesarean Sections in Rural Nepal

20-year trend in Caesarean section rates in primiparous women in a regional obstetric unit in Hong Kong

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