Department Pediatrics and Adolescent Medicine, National Collaborative Perinatal Neonatal Network, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America.
PLoS One. 2021 Apr 5;16(4):e0249557. doi: 10.1371/journal.pone.0249557. eCollection 2021.
Rate of cesarean section (CS), including elective CS has globally increased. Studies have found that term elective CS before 39 weeks of gestation is associated with increased risk of adverse respiratory outcomes.
To determine the rate of elective CS and examine the association between timing of elective term CS and adverse neonatal outcomes in a large population of Lebanese women.
A Multi-Center Study was conducted using data from the National Collaborative Perinatal Neonatal Network database. Simple and multivariable logistic regression models were used to examine the association between timing of term elective CS and adverse neonatal outcomes. Some of the neonatal adverse outcomes we examined included respiratory distress syndrome, admission to the NICU, and a composite of respiratory outcomes.
A total of 28,997 low risk mothers who delivered through primary and repeat elective CS were included in the study. Uncomplicated elective planned term CS constituted 25% of all CS deliveries in Lebanon. Primary and repeat CS at 37 weeks of gestation increased the odds of most of the studied adverse neonatal outcomes. There were few associations between CS and adverse neonatal outcomes at 38 weeks of gestation.
Term primary and repeat cesarean delivery prior to 39 weeks of gestation is associated with respiratory and other adverse neonatal outcomes. Delaying birth 1-2 weeks till 39 weeks of gestation can prevent 64-77% of adverse respiratory outcomes.
剖宫产率（包括选择性剖宫产）在全球范围内有所增加。研究发现，妊娠 39 周前择期剖宫产与不良呼吸结局风险增加有关。
在黎巴嫩大量妇女中，确定选择性剖宫产的比例，并研究择期足月剖宫产时机与不良新生儿结局之间的关系。
采用国家合作围产新生儿网络数据库的数据进行多中心研究。使用简单和多变量逻辑回归模型来研究足月选择性剖宫产时机与不良新生儿结局之间的关系。我们研究的一些新生儿不良结局包括呼吸窘迫综合征、新生儿重症监护病房（NICU）入院和呼吸结局的综合指标。
共纳入 28997 例低危产妇，她们通过初次和重复择期剖宫产分娩。在黎巴嫩，无并发症的择期计划足月剖宫产占所有剖宫产分娩的 25%。37 周时初次和重复剖宫产会增加大多数研究不良新生儿结局的几率。在 38 周时，剖宫产与不良新生儿结局之间的关联较少。
妊娠 39 周前的足月初次和重复剖宫产与呼吸和其他不良新生儿结局有关。将分娩时间延迟 1-2 周至 39 周可以预防 64-77%的不良呼吸结局。
