Immediate and Late Respiratory Morbidities in Children After Elective Cesarean Section: Comparison of Early-Term and Full-Term Cesarean Section

Elias Nasrallah, Reem Sayed Ahmad, Bshara Mansour, Iyad Jahshan, Nael Elias

Abstract

Background: An inverse relationship exists between the birth week and neonatal complications. However, there are not enough studies to show if there is a significant difference in the respiratory morbidity and mortality between children born at early term (37–38+6 wk) and those born at full term (39–40+6 wk) by elective cesarean section (CS).

Aim: To determine the association of early-term and full-term elective CS with immediate and late (5–8 y) respiratory morbidities.

Materials and Methods: The study was performed in 2 parts: the first part was a retrospective cohort study that included 118 neonates who were delivered by elective CS (62 early-term and 56 full-term neonates). Neonatal data of these children were collected from the medical records and compared between the 2 groups (early term and full term). The second part was a prospective cohort study that included 24 children born early-term and 17 children born at full-term, who were randomly selected. These children underwent pulmonary function test, and their parents were asked to fill out a questionnaire.

Results: In the retrospective study, the early-term group had a significantly lower 1-minute Apgar score (8.82 ± 0.64) compared with that of the full-term group (9.02 ± 1.34) (P = .022). In the prospective study, the early-term group had lower forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and forced expiratory flow (FEF) compared with that of the full-term group (FEV1: 1.22 ± 0.24 vs 1.62 ± 0.53 [P = .02]; FVC: 1.39 ± 0.27 vs 1.92 ± 0.6 [P = .001]; and FEF: 1.68 ± 0.5 vs 2.04 ± 0.57 [P = .035], respectively).

Conclusions: Early and late respiratory morbidities are more common in the early-term children compared with that in full-term children born by elective CS.