Author/Authors :
Choudhary Bharat نويسنده Department of Pediatrics, All India Institute of Medical
Sciences, Bhopal, MP, India , Choudhary Yachana نويسنده Department of Community Medicine, Gandhi Medical College,
Bhopal, MP, India , Pakhare Abhijit P نويسنده Department of Community and Family Medicine, All India
Institute of Medical Sciences, Bhopal, MP, India , Mahto Deonath نويسنده Department of Pediatrics, Lady Harding Medical College,
New Delhi, India , Chaturvedula Latha نويسنده Department of Obstetrics and Gynaecology, Jawaharlal
Institute of Postgraduate Medical Education and Research Puducherry,
India
Abstract :
Objectives To find out the early neonatal outcome (morbidity and
early neonatal mortality) of the babies born by caesarean section (CS)
and to compare the outcomes between elective and emergency CS. Methods A
longitudinal study was conducted in a tertiary care hospital. Maternal
and neonatal characteristics were noted. Results A total of 750 neonates
were enrolled and 37% were born by elective CS. Out of 750 children 55%
were male newborns and 45% were females. The NICU (neonatal intensive
care unit) admission requirement was 24%, whereas 3.33% of neonates died
within 7 days of life. Neonatal morbidity was higher in emergency CS,
similar to respiratory depression at birth (OR: 6.00, 95% CI 3.06-11.78,
P < 0.001), respiratory distress (OR: 4.6, 95% CI 2.74 -7.82, P
< 0.001) and requirement of resuscitation (OR: 5.54, 95% CI 2.98
-10.32, P < 0.001). Factors such as emergency CS [adj OR:
13.35(1.69 -105.38), P = 0.014], prematurity [adj OR: 10.08 (3.33
-30.47), P < 0.001] and Apgar score < 7 at 10 minutes [adj
OR: 79.56 (16.63 - 381.50), P < 0.001] were independently
associated with NICU admissions and neonatal mortality. Conclusions
Newborns delivered through emergency CS had a higher morbidity and
mortality rate compared to elective CS. Adequate antenatal care and
early referral may convert this emergency CS to normal or elective CS
and can reduce neonatal morbidity and mortality.
