ABSTRACT
We compared the short-term maternal and neonatal outcomes of women who deliver by
cesarean without labor compared with women who deliver by cesarean after labor or
by vaginal birth. This was a retrospective cohort study of women delivering a first
baby from 1998 to 2002. Hospital discharge diagnostic coding identified unlabored
cesarean deliveries (UCDs), labored cesarean deliveries (LCDs), and vaginal births
(VBs). Medical records were abstracted and mode of delivery confirmed. The three outcomes
of interest were maternal bleeding complications, maternal febrile morbidity, and
neonatal respiratory complications. Using logistic regression for each outcome, we
investigated whether mode of delivery was associated with the outcome, independent
of other factors. The study groups included 513 UCDs, 261 LCDs, and 251 VBs. Compared
with the UCD group, the adjusted odds of bleeding complications was higher in the
LCD comparison group (odds ratio [OR] 2.3; 95% confidence interval [CI] 1.21, 4.53)
and the VB comparison group (OR 1.96; 95% CI 0.95, 4.02). The incidence of febrile
morbidity was similar for both cesarean groups but lower in the VB group. Both comparison
groups had lower odds of neonatal complications than the UCD group (OR for LCD comparison
group 0.52; 95% CI 0.27, 0.95 and OR for VB comparison group 0.26; 95% CI 0.098, 0.59).
Scheduled cesarean is associated with increased odds of neonatal respiratory complications
but decreased odds of maternal bleeding complications.
KEYWORDS
Cesarean morbidity - elective cesarean - neonatal complications - maternal complications
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Lieschen H QuirozM.D.
Clinical Instructor, Department Gynecology and Obstetrics, Johns Hopkins University
School of Medicine
4940 Eastern Ave. Suite 121, Baltimore MD 21224
eMail: lhq@aol.com
