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Early C-Sections Risky

Jan 8, 2009 | Parker Waichman LLP Babies are at greater risk for serious health problems and birth injuries when delivered by early cesarean section.  According to a new study, over one-third of all American babies—those born via planned and repeat C-section prior to 39 weeks gestation—are at increased risk for birth-related problems, reports WebMD.

C-section births accounted for one in every five births ten years ago; that number has increased, said WebMD.  It seems that women who have undergone at least one C-section are likelier to proceed with a C-section and not a vaginal birth for subsequent pregnancies, WebMD explained, adding that, according to national figures 40 percent of the annual 1.3 million C-section births performed are repeat, with most being planned procedures.

The American College of Obstetrics and Gynecology (ACOG) suggests that unless medically necessary, such planned, elective procedures prior to the 39-week gestational mark should not be considered unless testing confirms the baby's lungs are mature enough for delivery, said WebMD.  US News and World Reports HealthDayNews added that delivering a baby just two weeks earlier doubles the risks that the baby will experience breathing problems requiring mechanical ventilator intervention; infection, such as the blood infection newborn sepsis; and low blood sugar.  At 38 weeks, the complication rate is 1.5 times increased.  WebMD reported that, according to the study, babies born between their 37th and 38th weeks experienced up to four times the risks.

HealthDayNews quoted Dr. Alan T.N. Tita, study lead and assistant professor of obstetrics and gynecology and an epidemiologist at the University of Alabama at Birmingham as saying that, "About 36 percent of women were delivered prior to 39 weeks, electively by Caesarean.  These early deliveries were associated with adverse outcomes.  There was a two-fold increase in morbidity in those delivered at 37 weeks compared to women delivered at 39 weeks." The study appears in the January 8 issue of the New England Journal of Medicine.

The new study looked at 13,258 women who underwent elective, repeat C-section deliveries at one of 19 U.S. academic medical centers affiliated with the Eunice Kennedy Shriver National Institute of Child Health and Human Development's Maternal-Fetal Medicine Units Network, said HealthDayNews.  Dr. Peter Bernstein, a maternal-fetal medicine specialist at Montefiore Medical Center and Albert Einstein College of Medicine in New York City, said that while the increase in complications was not surprising, "The bigger surprise to me was that nearly 36 percent of elective procedures were done before the 39th week”, reported HealthDayNews.  "The institutions that participate in this network are big academic centers," Bernstein said. "In the academic world, these are among the top institutions, and that more than one-third apparently aren't following ACOG guidelines is a surprise," he added.

WebMD said that the study found that planned, repeat, early C-section procedures were being performed on women who were insured, older, and married.  Also, women who want to have their babies delivered by their own doctor are also more likely to schedule the birth, working around the doctors’ schedules rather than leave the performing physician up to chance and the baby’s timing.

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