Timing of elective Caesarean section at term on neonatal morbidities

Objective: To compare the incidence of neonatal morbidities with elective Caesarean sections at different weeks of gestation in Hong Kong. Methods: Medical records of all women with an elective Caesarean section performed at gestational age 37 weeks in Queen Elizabeth Hospital, Hong Kong, between 1 January 2016 and 31 December 2018 were retrospectively reviewed. Adverse neonatal outcomes collected included respiratory distress syndrome, transient tachypnoea, persistent pulmonary hypertension, sepsis, and neonatal intensive care unit admission. Results: A total of 1576 records were analysed. Overall, 74.68% of babies were delivered at 38 weeks' gestation. The most common adverse neonatal outcome was transient tachypnoea (6.66%), followed by neonatal intensive care unit admission (5.90%), respiratory distress syndrome (5.26%), and sepsis (4.69%). Compared with babies born at 39 weeks' gestation, those born at 37 weeks' gestation were at increased risk of respiratory distress syndrome (odds ratio [OR]=5.348, p=0.024), neonatal intensive care unit admission (OR=3.938, p=0.027), a composite respiratory outcome (OR=3.402, p=0.007), and an overall composite outcome (OR=3.397, p=0.002).