Am J Perinatol 2010; 27(10): 797-802
DOI: 10.1055/s-0030-1254549
© Thieme Medical Publishers

Transient Tachypnea of the Newborn: Is Labor Prior to Cesarean Delivery Protective?

Michelle Silasi1 , Dean V. Coonrod2 , 4 , Matthew Kim5 , David Drachman3
  • 1Women and Infants' Hospital, Providence, Rhode Island
  • 2Department of Obstetrics and Gynecology, Maricopa Integrated Health System/District Medical Group, Phoenix, Arizona
  • 3Research Department, Maricopa Integrated Health System, Phoenix, Arizona
  • 4University of Arizona College of Medicine, Phoenix, Arizona
  • 5Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California
Further Information

Publication History

Publication Date:
19 May 2010 (online)

ABSTRACT

Transient tachypnea of the newborn (TTN) is a common respiratory problem in newborns. This study aims to determine if cesarean delivery (CD) is a risk factor for TTN, and if labor prior to CD decreases this risk. A linked data set consisting of Arizona birth certificates (1994 to 1998) and infants enrolled in a high-risk perinatal program provided 800 TTN cases and 800 controls, stratified by year. The relationships of CD and labor to TTN were examined using logistic regression. CD was associated with an increased risk of TTN, whether it was accompanied by labor (odds ratio [OR] 2.68; 95% confidence interval [CI] 1.62 to 4.45) or not accompanied by labor (OR 2.88; 95% CI 2.01 to 4.13), even after adjusting for confounding variables. Labor did not affect the development of TTN, nor did it modify the association of CD with increased risk for TTN. CD is a risk factor for TTN. Labor prior to CD is not protective for TTN.

REFERENCES

  • 1 Taussig L, Laundau L Pediatric Respiratory Medicine. St. Louis; Mosby 1999
  • 2 Hook B, Kiwi R, Amini S B, Fanaroff A, Hack M. Neonatal morbidity after elective repeat cesarean section and trial of labor.  Pediatrics. 1997;  100(3 Pt 1) 348-353
  • 3 Levine E M, Ghai V, Barton J J, Strom C M. Mode of delivery and risk of respiratory diseases in newborns.  Obstet Gynecol. 2001;  97 439-442
  • 4 Morrison J J, Rennie J M, Milton P J. Neonatal respiratory morbidity and mode of delivery at term: influence of timing of elective caesarean section.  Br J Obstet Gynaecol. 1995;  102 101-106
  • 5 Riskin A, Abend-Weinger M, Riskin-Mashiah S, Kugelman A, Bader D. Cesarean section, gestational age, and transient tachypnea of the newborn: timing is the key.  Am J Perinatol. 2005;  22 377-382
  • 6 Jain L, Dudell G G. Respiratory transition in infants delivered by cesarean section.  Semin Perinatol. 2006;  30 296-304
  • 7 Gerten K A, Coonrod D V, Bay R C, Chambliss L R. Cesarean delivery and respiratory distress syndrome: does labor make a difference?.  Am J Obstet Gynecol. 2005;  193(3 Pt 2) 1061-1064
  • 8 Breslow N E, Day N E. The Design and Analysis of Cohort Studies. Statistical Methods in Cancer Research, Vol. II. Lyon; IARC Scientific Publications 1987
  • 9 Kotelchuck M. An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index.  Am J Public Health. 1994;  84 1414-1420
  • 10 Cohen M, Carson B S. Respiratory morbidity benefit of awaiting onset of labor after elective cesarean section.  Obstet Gynecol. 1985;  65 818-824
  • 11 De Luca R, Boulvain M, Irion O, Berner M, Pfister R E. Incidence of early neonatal mortality and morbidity after late-preterm and term cesarean delivery.  Pediatrics. 2009;  123 e1064-e1071
  • 12 Hansen A K, Wisborg K, Uldbjerg N, Henriksen T B. Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study.  BMJ. 2008;  336 85-87
  • 13 Tutdibi E, Gries K, Bücheler M, Misselwitz B, Schlosser R L, Gortner L. Impact of labor on outcomes in transient tachypnea of the newborn: population-based study.  Pediatrics. 2010;  125 e577-e583
  • 14 Jain L, Eaton D C. Physiology of fetal lung fluid clearance and the effect of labor.  Semin Perinatol. 2006;  30 34-43

Dean V CoonrodM.D. M.P.H. 

Associate Professor of Clinical Obstetrics and Gynecology, University of Arizona College of Medicine

2601 E. Roosevelt, Phoenix, AZ 85008

Email: dean_coonrod@dmgaz.org

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