Impact of Rising Elective Cesarean Section Rates on Early Neonatal Outcome

Abstract

Background: The increased rate of elective cesarean sections (CS) has been a significant health concern worldwide due to which many long-term and short-term neonatal and maternal complications are arising. This study aimed to assess the early neonatal outcomes of elective CS and compare these outcomes with emergency CS. Methods: A cross-sectional study was conducted using convenience sampling from March to August 2023 at Fazaia Ruth Pfau Medical College, Karachi. A total of 184 neonates born between 36 to 42 weeks gestational age delivered via elective c-section for uncomplicated single pregnancy were included. The percentage, frequency, and odds ratio were calculated using SPSS 23 with a p-value<0.05 considered significant. Results: Out of 184 neonates, 104(57%) were born by elective LSCS and 79(43%) by emergency LSCS. Respiratory morbidities were observed in 24(23%) of neonates born via elective c-section with 40(38%) needing oxygen therapy and 8(7.6%) ventilator support. Neonatal Jaundice was significantly more common in elective LSCS 56(53.3%) while neonatal sepsis was higher in emergency LSCS 64(81%). Meconium aspiration syndrome (aOR 0.07 95%CI 0.01-0.32, p-0.001) and babies born between 36 and 38 weeks gestation (aOR 0.37 95%CI 0.18 – 0.75, p-0.001) were considerably less likely to have been delivered by elective LSCS. Neonates with shorter hospital stays of <3 days were more likely to have been delivered by elective LSCS (aOR 10.0 95%CI 1.16-85.5, p-0.012). Conclusion: Elective CS can have unintended consequences related to respiratory morbidity, neonatal sepsis, and jaundice. The brief hospital stays following an elective C-section are the positive aspects of our study. Keywords: Cesarean Section, Meconium Aspiration Syndrome, Neonates, Pregnancy Complications, Respiratory Distress Syndrome, Sepsis.