Timing for elective cesarean and maternal fetal outcome: a retrospective cohort

Objective: To assess the relationship between the timing of elective cesarean section (C-section) and neonatal outcomes in a Brazilian population. Methods: : Retrospective cohort study including women with single gestation submitted to elective C-section from January 2013 to December 2016. Eligibility criteria included primiparous mothers and those who previously underwent a C-section, with gestational ages of 37–39 weeks (group I) or ≥ 39 weeks (group II), undergoing antepartum elective C-section without clinical indication. Main Outcomes and Measures: adverse neonatal outcomes (NICU admission, respiratory distress, hypoglycemia, hiperbilirrubinemia, neonatal infection and meconium aspiration syndrome) Results: : There were 17,184 live births at Hospital Moinhos de Vento during the study period. Of these, remaining 3,722 C-sections without medical indication in nulliparous women or in those with one previous C-section. Of these, 1,460 were in group I and 2,262 were in group II. Neonatal intensive care unit (NICU) hospitalization, respiratory distress and hyperbilirubinemia were positively associated with group I in relation to group II (p≤0.0001, p=0.001 and p=0.002, respectively). Conclusion: Elective C-section based on maternal request should not be recommended; however, for women who require elective C-section, neonatal outcomes suggest that delivery between 39 and 39+7 weeks is the optimal timing.