{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:23:06Z","timestamp":1785414186096,"version":"3.56.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,4,26]],"date-time":"2018-04-26T00:00:00Z","timestamp":1524700800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1082548"],"award-info":[{"award-number":["GNT1082548"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2019,4]]},"abstract":"Background<\/jats:title>Since caesarean sections (CS<\/jats:styled-content>s) before 39+0<\/jats:sup>\u00a0weeks gestation are associated with higher rates of neonatal respiratory morbidity, it is recommended to delay elective CS<\/jats:styled-content>s until 39+0<\/jats:sup>\u00a0weeks. However, this bears the risk of earlier spontaneous labour resulting in unplanned CS<\/jats:styled-content>s, which has workforce and resource implications, specifically in smaller obstetric units.<\/jats:p><\/jats:sec>Aim<\/jats:title>To assess, in a policy of elective CS<\/jats:styled-content>s from 39+0<\/jats:sup>\u00a0weeks onward, the number of unplanned CS<\/jats:styled-content>s to prevent one neonate with respiratory complications, as compared to early elective CS<\/jats:styled-content>.<\/jats:p><\/jats:sec>Materials and Methods<\/jats:title>We performed a decision analysis comparing early term elective CS<\/jats:styled-content> at 37+0\u20136<\/jats:sup> or 38+0\u20136<\/jats:sup>\u00a0weeks to elective prelabour CS<\/jats:styled-content>, without strict medical indication, at 39+0\u20136<\/jats:sup>\u00a0weeks, with earlier unplanned CS<\/jats:styled-content>, in women with uncomplicated singleton pregnancies. We used literature data to calculate the number of unplanned CS<\/jats:styled-content>s necessary to prevent one neonate with respiratory morbidity.<\/jats:p><\/jats:sec>Results<\/jats:title>Planning all elective CS<\/jats:styled-content>s at 39+0\u20136<\/jats:sup>\u00a0weeks required 10.9 unplanned CS<\/jats:styled-content>s to prevent one neonate with respiratory morbidity, compared to planning all elective CSs<\/jats:styled-content> at 38+0\u20136<\/jats:sup>\u00a0weeks. Compared to planning all elective CS<\/jats:styled-content>s at 37+0\u20136<\/jats:sup>\u00a0weeks we needed to perform 3.3 unplanned CS<\/jats:styled-content>s to prevent one neonate with respiratory morbidity.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In a policy of planning all elective pre\u2010labour CS<\/jats:styled-content>s from 39+0<\/jats:sup>\u00a0weeks of gestation onward, between three and 11 unplanned CS<\/jats:styled-content>s have to be performed to prevent one neonate with respiratory morbidity. Therefore, in our opinion, fear of early term labour and workforce disutility is no argument for scheduling elective CS<\/jats:styled-content>s <39+0<\/jats:sup>\u00a0weeks.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12821","type":"journal-article","created":{"date-parts":[[2018,4,27]],"date-time":"2018-04-27T06:36:44Z","timestamp":1524811004000},"page":"221-227","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Timing of elective pre\u2010labour caesarean section: A\u00a0decision analysis"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4692-1115","authenticated-orcid":false,"given":"Freke A.","family":"Wilmink","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Radboudumc Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4509-5368","authenticated-orcid":false,"given":"Clarabelle T.","family":"Pham","sequence":"additional","affiliation":[{"name":"School of Public Health University of Adelaide Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Edge","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Mildura Base Hospital Mildura Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal W.P.M.","family":"Hukkelhoven","sequence":"additional","affiliation":[{"name":"Perined Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A.P.","family":"Steegers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Erasmus MC \u2013 Sophia Children's Hospital Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben W.","family":"Mol","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology The Robinson Research Institute University of Adelaide North Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,26]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Australia's mothers and babies 2015 \u2010 in brief","author":"Australian Institute of Health and Welfare","year":"2017"},{"key":"e_1_2_7_3_1","volume-title":"Australia's mothers and babies 2012","author":"Hilder L","year":"2014"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1097\/00006250-200103000-00023","article-title":"Mode of delivery and risk of respiratory diseases in newborns","volume":"97","author":"Levine EM","year":"2001","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.05.005"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39405.539282.BE"},{"key":"e_1_2_7_7_1","unstructured":"National Institute for Health and Care Excellence.Caesarean section (CG132)[Internet] 2012. 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