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 The Danes and Brits have recently delivered information to the scientific world that is obvious to a lot of us -- that babies delivered by elective Cesarean sections are more likely to have respiratory problems than those delivered vaginally or by emergency surgery. Researchers studied more than 34,000 births at a Danish hospital, 2,687 of which were elective surgical births. It’s no surprise that the younger the gestational age, the greater the chance of respiratory problems the newborn encountered.
"The reason is unclear," The British Medical Journal reports, adding that "researchers theorize that hormonal and physiological changes in labor might help fetal lungs mature properly." This isn’t rocket science: Babies allowed to do their job -- starting
up their mother's labor when the time is right -- fare better. One
would hope this to be the foundation of Obstetrics 101 classes. No
matter how fancy the measuring machine, despite a caregiver's best
intuitive gifts, even though a hospital's newborn intensive care unit
is state-of-the-art, nature still holds the winning hand. Allow labor
and birth to unfold at their intended pace, and most babies will come
into the world with their little body systems developed and ready to
meet the challenge of life outside mama.
Birthing: Elective Caesareans Tied to Breathing Problems
By Nicholas Bakalar, The New York Times
December 25, 2007
Babies delivered by elective Caesarean sections are significantly more likely to have respiratory problems than those delivered vaginally or by emergency surgery, a new study finds.
Researchers studied 34,458 successive live single births at a hospital in Aarhus, Denmark; 2,687 were elective Caesareans. The study was published online on Dec. 11 in The British Medical Journal.
The younger the gestational age, the more breathing problems there were for all babies, and the authors emphasized that the risk was small for all groups.
Still, the increased risk for the elective Caesarean babies was notable. At 37 weeks, they were almost four times as likely as others of the same gestational age to have respiratory problems, at 38 weeks three times as likely, and at 39 weeks almost twice as likely.
The differences remained even after controlling for maternal age, smoking, alcohol intake and other variables.
The reason is unclear. The researchers theorize that hormonal and physiological changes in labor might help fetal lungs mature properly.
"We know that the earlier a baby is born, the more immature the lungs," said Dr. Anne Kirkeby Hansen, the lead author and a research fellow at Aarhus University Hospital. "According to our study, it would be a good idea to postpone elective Caesareans until 39 weeks, even though we know that some women might go into spontaneous labor before that date."
On the Web: Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study (The British Medical Journal)
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