Early C-section may put the baby at risk

Birmingham, January 8: Elective Caesarean deliveries before the 39th week of pregnancy put the babies at a risk of breathing problems and other complications, according to a study published in The New England Journal of Medicine, on Wednesday.

More than 50 percent of C-section deliveries are done by patients’ choice and about one-third of them are carried out before the right time, said the researchers.

Although a fetus is known to reach complete development in 37 weeks, most medical experts insist on waiting to complete 39-weeks before an elective C-section is performed.

For a Caesarean delivery at 38 weeks, the risk of complications was 50 percent higher, said the researchers."Even those deliveries done about three days prior to 39 weeks still have an increase in these adverse outcomes," said lead author Dr. Alan Tita of the University of Alabama at Birmingham.

The study involved more than 24,000 women who underwent C-sections at 37 weeks or later at 19 U.S. medical centers, between 1999 and 2002. Of those, 13,258 women had opted for C-section, although it was not required by the medical science.

C-section deliveries are popular because they are seen as a convenient method by the mother and the doctor, as compared to a normal delivery.

However, the method has been controversial for long and health officials have repeatedly asserted a reduction in their frequency, which would not only minimize post-partum complications but also help reduce costs.

Since 37-weeks is the widely-accepted full term for a fetus, “women, I believe, when they attain this gestational age, are tired of the pregnancy, they're excited to see the newborn and they start asking to be delivered,” said Dr. Tita. “So I think part of it is the pressure from the patients who want to be delivered and physicians who want to accommodate their patients.”

Also, according to Dr. Michael Greene of Massachusetts General Hospital, there is a possibility for women to be eager to get the delivery done by their own doctor.

"To accommodate busy schedules and to minimize the chance that a patient will begin labor and require a nonelective procedure when her doctor might not be available, procedures are frequently scheduled just before 39 weeks of gestation," he said.

The term for a normal pregnancy can last from 37 to 42 weeks, according to the American College of Obstetricians and Gynecologists, a nonprofit advocate for women's health care.

The recent study also suggests against waiting too long for the delivery as complications were found to rise after 41 weeks. That leaves “a relatively narrow two-week window of minimal risk in which elective repeat Cesarean deliveries could optimally be performed," said Greene.