JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2016, Vol. 54 ›› Issue (5): 56-61.doi: 10.6040/j.issn.1671-7554.0.2015.986

Previous Articles     Next Articles

Influencing factors of adverse outcomesin term neonates delivered by elective caesarean

HONG Haijie1, SUN Wenjuan1, ZHANG Yuan2, XU Yongping1   

  1. 1. Department of Obstetrics;
    2. Center of Evidence-based Medicine, the Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Received:2015-10-17 Online:2016-05-16 Published:2016-05-16

PDF (PC)

308

Abstract: Objective To analyze the influencing factors of adverse outcomes in neonates delivered at term by elective caesarean. Methods Clinical data of mothers and babies delivered by elective caesarean section during Nov.1, 2011 and Oct.31, 2014 at the Second Hospital of Shandong University were retrospectively reviewed. The neonatal adverse outcomes were analyzed with t-test, chi-square test and logistic regression analysis, including transference to NICU and respiratory diseases. Results A total of 3,290 mothers and their neonates were enrolled, of which 250 neonates needed to be transferred to NICU, and 110 neonates developed a respiratory disease. The factors that caused the neonates to be transferred to NICU were parity, BMI, delivery gestational age and fetal sex. The factors that caused the neonates to develop a respiratory disease were parity, delivery gestational age and fetal sex. The risk of adverse outcomes in neonates whose mothers parity was three times and above was significantly higher. The risk of transference to NICU was lower in neonates delivered by mothers with smaller BMI. The risk of transference to NICU for neonates delivered in 山 东 大 学 学 报 (医 学 版)54卷5期 -洪海洁,等.足月选择性剖宫产分娩新生儿不良结局的影响因素 \=-37+0-6 weeks was 1.9 times than those delivered in 39+0-7 weeks(OR=1.9, 95%CI=1.2-3.0). The risk of respiratory disease for neonates delivered in 37+0-6 weeks and 38+0-6 weeks were respectively 2.5 times and 1.8 times than those delivered in 39+0-7 weeks(OR=2.5, 95%CI=1.4-4.7 and OR=1.8, 95%CI=1.1-2.7). The risk of a respiratory disease and transference to NICU in male neonates were respectively 2.2 times and 1.3 times than in female neonates(OR=2.2, 95%CI=1.4~3.4 and OR=1.3, 95%CI=1.0-1.7). The differences were statistically significant(all P<0.05). Conclusion The best delivery gestational age for elective cesarean section is 39-40 weeks. Cesarean sections conducted shortly after onset of labor do not reduce the risk of neonatal adverse outcomes. The risk of adverse outcomes in male neonates is higher than in female neonates. The risk of neonatal adverse outcomes in mothers with higher BMI, or whose parity is three times and above is increased.

Key words: Term baby, Cesarean section, Elective, Neonatal adverse outcomes, Influencing factors

CLC Number: 

  • R719.8
[1] Souza JP, Gülmezoglu AM, Lumbiganon P, et al. Caesarean section without medical indications is associated with an increased risk of adverse shorter maternal outcomes: the 2004-2008 WHO global survey on maternal and perinatal health [J]. BMC Med, 2010, 8: 71. doi: 10.1186/1741-7015-8-71.
[2] Wilmink FA, Hukkelhoven CW, Lunshof S, et al. Neonatal outcome following elective cesarean section beyond 37 weeks of gestation: a 7-year retrospective analysis of a national registry [J]. Am J Obstet Gynecol, 2010, 202(3): 250.e1-8.
[3] Terada K, Ito M, Kumasaka S, et al. Timing of elective cesarean singleton delivery and neonatal respiratory outcomes at a Japanese perinatal center[J]. J Nippon Med Sch, 2014, 81(4):285-288.
[4] Doan E, Gibbons K, Tudehope D.The timing of elective caesarean deliveries and early neonatal outcomes in singleton infants born 37-41 weeks gestation[J]. Aust N Z J Obstet Gynaecol, 2014, 54(4):340-347.
[5] Glavind J, Uldbjerg N. Elective cesarean delivery at 38 and 39 weeks: neonatal and maternal risks[J]. Curr Opin Obstet Gynecol, 2015, 27(2):121-127.
[6] 郭琦, 李雷, 边旭明. 足月择期剖宫产的时机与新生儿结局的分析[J]. 中华围产医学杂志, 2011, 14(1): 12-18. GUO Qi, LI Lei, BIAN Xuming, et al. Timing of elective cesarean delivery at term and neonatal outcomes[J]. Chin J Perinat Med, 2011, 14(1):12-18.
[7] Morrison JJ, Rennie JM, Milton PJ. Neonatal respiratory morbidity and mode of delivery at term: influence of timing of elective caesarean section[J]. Br J Obstet Gynaecol, 1995, 102(2):101-106.
[8] Zanardo V, Simbi AK, Franzoi M, et al. Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective caesarean delivery[J]. Acta Paediatr, 2004, 93(5):643-647.
[9] Hansen AK, Wisborg K, Uldbjerg N, et al. Risk of respiratory morbidity in term infants delivered by elective cesarean section: cohort study[J]. BMJ, 2008, 336(7635):85-87.
[10] Kolas T, Saugstad OD, Daltveit AK, et al. Planned cesarean versus planned vaginal delivery at term: comparison of newborn infant outcomes[J]. Am J Obstet Gynecol, 2006, 195(6):1538-1543.
[11] Senturk MB, Cakmak Y, Gündogˇdu M, et al. Does performing cesarean section after onset of labor has positive effect on neonatal respiratory disorders?[J]. J Matern Fetal Neonatal Med, 2015, 18: 1-4.[Epub ahead of print].
[12] Glavind J, Kindberg SF, Uldbjerg N, et al. Elective caesarean section at 38 weeks versus 39 weeks: neonatal and maternal outcomes in a randomised controlled trial[J]. BJOG, 2013, 120(9):1123-1132.
[13] Vilchez G, Chelliah A, Argoti P, et al. Maternal race and neonatal outcomes after elective repeat cesarean delivery[J]. J Matern Fetal Neonatal Med, 2014, 27(4):368-371.
[14] Chiossi G, Lai Y, Landon MB, et al. Timing of delivery and adverse outcomes in term singleton repeat cesarean deliveries[J]. Obstet Gynecool, 2013, 121(3):561-569.
[15] Hutcheon JA, Strumpf EC, Harper S, et al. Maternal and neonatal outcomes after implementation of a hospital policy to limit low-risk planned caesarean deliveries before 39 weeks of gestation: an interrupted time-series analysis[J]. BJOG, 2015, 122(9):1200-1206.
[16] Ertugrul S, Gün I, Müngen E, et al. Evaluation of neonatal outcomes in elective repeat cesarean delivery at term according to weeks of gestation [J]. J Obstet Gynaecol Res, 2013, 39(1):105-112.
[17] Mohammed AB, Bayo AI, Abu-Jubara MF. Timing of elective repeated cesarean delivery in patients with previous two or more cesarean section[J]. J Matern Fetal Neonatal Med, 2013, 26(1):10-12.
[18] 刘洪莉, 漆洪波, 罗欣. 择期选择性剖宫产终止妊娠的时机及母儿结局[J]. 中华围产医学杂志, 2014, 17(4):224-229. LIU Hongli, QI Hongbo, LUO Xin, et al. Timing of elective repeat cesarean delivery and maternal and neonatal outcomes[J]. Chin J Perinat Med, 2014, 17(4):224-229.
[19] Melamed N, Hadar E, Keidar L, et al. Timing of planned repeat cesarean delivery after two or more previous cesarean sections-risk for unplanned cesarean delivery and pregnancy outcome[J]. J Matern Fetal Neonatal Med, 2014, 27(5):431-438.
[20] Yee W, Amin H, Wood S. Elective cesarean delivery, neonatal intensive care unit admission, and neonatal respiratory distress[J]. Obestet Gynecol, 2008, 111(4):823-828.
[21] Riskin A, Gonen R, Kugelman A, et al. Does cesarean section before the scheduled date increase the risk of neonatal morbidity?[J]. Isr Med Assoc J, 2014, 16(9):559-563.
[22] Carey MA, Card JW, Voltz JW, et al. The impact of sex and sex hormones on lung physiology and disease: lessons from animal studies[J]. Am J Physiol Lung Cell Mol Physiol, 2007, 293(2):L272-278.
[23] Crane JM, Murphy P, Burrage L, et al. Maternal and perinatal outcomes of extreme obesity in pregnancy[J]. J Obstet Gynaecol Can, 2013, 35(7):606-611.
[1] CUI Meng, ZHENG Jilu, TIAN Sinan, LI Lianjun, ZHANG Qi, JIN Xunbo, WANG Muwen. Photoselective vaporization of the prostate for the treatment of benign prostatic obstruction in patients with Parkinsons disease [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(7): 100-102.
[2] LI Jiangbing, SONG Xinhong, LIN Haiyan, ZHANG Dongzhi, LI Xiangyi, XU Yibo, WANG Li, XUE Fuzhong. The influencing factors of ischemic ECG abnormalities in a large health check-up population [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 77-81.
[3] SHANG Jianqiang. Role of intravascular interventional therapy in cesarean section for pernicious placenta previa complicated with placenta accreta [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(9): 14-17.
[4] LI Jijun, ZUO Changting, WANG Xietong, SHANG Jianqiang. Application of abdominal aorta balloon occlusion in cesarean section for patients with pernicious placenta previa complicated by placenta accreta [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(9): 22-25.
[5] GAI Linlin, GUAN Lixue, LI Haibo, CHU Jinjin, ZHU Yun, LI Ming. Screening results and influencing factors of T-SPOT.TB assay in patients with autoimmune rheumatic diseases [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(6): 82-86.
[6] WANG Yihua, MA Lin, KAN Yanmin, WANG Wentao. Early ultrasound observation of uterine incision defect after cesarean section and analysis of related factors [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(5): 39-44.
[7] DING Lilu, SUN Qiang. Path analysis for influencing factors of the total health expenditure of China [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(12): 86-89.
[8] GUO Bin, WANG Xinhai, XU Lingzhong, GAI Ruoyan. Mental health status and influencing factors in preschoolers in rural areas of Shandong Province [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(1): 87-92.
[9] HUANG An-cui, TIAN Wei-yun. Application of strap-uterine suture in caesarean postpartum hemorrhage [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(S1): 43-44.
[10] LI Jianzhuo, JIN Yan, YANG Hui, LI Xinrui, HU Yanxia, ZHANG Changqing, ZHU Yanwen, RUAN Shiman. Influencing factors of drug treatment compliance among patients with HIV/AIDS in Jinan city of China [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(3): 106-110.
[11] LI Ming1, YANG Hua2, GAO Qian-qian1, LI Shi-xue1. Analysis of burden of family long-term caregivers for disabled elders in Jinan city and influencing factors [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(9): 109-112.
[12] ZHOU Yan1, GUO Li-xin1, ZHOU Lu2, WANG Yao1, MOU Zhong-qing1, WANG Xiao-xia1, YU Dong-ni1， ZHANG Li-na1. Factors influencing diabetic peripheral neuropathy in
elderly type 2 diabetic patients [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(6): 1-4.
[13] WANG Jing-chen1,2, YUAN Miao2, LIU Guang-li2， FENG Hao2， RONG Feng-nian2. Effects of pregnancy and childbirth on female pelvic  support floor [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(12): 82-86.
[14] ZHONG Hao, LI Bo, WANG Jin, WEI Chun-xiao, JIN Xun-bo. Effect of straight light beam greenlight PVP for the
treatment of benign prostatic hyperplasia [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(11): 88-.
[15] ZHAO Xiu-xiu, XU Ling-zhong, GUO Zhen, YANG Ping. Analysis on diagnostic delay of tuberculosis patients and
its influencing factors [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(11): 122-125.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd