{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:14:12Z","timestamp":1793423652112,"version":"4.5.0"},"reference-count":19,"publisher":"Walter de Gruyter GmbH","issue":"7","funder":[{"DOI":"10.13039\/100008982","name":"Qatar National Research Fund","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008982","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Medical Research Centre, Hamad Medical Corporation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpm-2020-0402_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To examine the impact of early term caesarean section (CS) on respiratory morbidity and early neonatal outcomes when elective caesarean section was carried out before 39 completed weeks gestation in our population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2020-0402_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A one-year population-based retrospective cohort analysis using routinely collected hospital data. Livebirths from women who had elective lower segment cesarean section (ELSCS) for uncomplicated singleton pregnancies at early term (ET) 37+0 to 38+6 weeks were compared to full term (FT)\u226539+0 weeks gestation. Exclusion criteria included diabetes, antenatal corticosteroid use, stillbirths, immediate neonatal deaths, normal vaginal deliveries and emergency caesareans sections. The outcomes were combined respiratory morbidity (tachypnea [TTN] and respiratory distress syndrome [RDS]), Apgar &lt;7 at 5\u00a0min of age, respiratory support, duration of respiratory support and NICU admission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2020-0402_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Out of a total of 1,466 elective CS with term livebirths, the timing of CS was early term (ET) n=758 (52%) and full term (FT) n=708 (48%). There was a higher incidence of respiratory morbidities and neonatal outcomes in the ET in comparison to FT newborns. In the univariable analysis, significant risks for outcomes were: the need for oxygen support OR 2.42 (95% C.I. 1.38\u20134.22), respiratory distress syndrome and\/or transient tachypnea of newborn (RDSF\/TTN) OR 2.44 (95% C.I. 1.33\u20134.47) and neonatal intensive care unit (NICU) admission OR 1.91 (95% C.I. 1.22\u20132.98). Only the need for oxygen support remained (OR 1.81, 95% C.I. 1.0\u20133.26) in the multivariable analysis. These results were observed within the context of a significantly higher proportion of older, multiparous, and higher number of previous caesarean sections in the early term CS group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2020-0402_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There is a significant risk of respiratory morbidities in infants born by elective cesarean section prior to full term gestation. Obstetricians should aim towards reducing the high rate of women with previous multiple cesarean sections including balancing the obstetric indication of early delivery among such women with the evident risk of neonatal respiratory morbidity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpm-2020-0402","type":"journal-article","created":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T01:25:41Z","timestamp":1620782741000},"page":"767-772","source":"Crossref","is-referenced-by-count":27,"title":["The neonatal respiratory morbidity associated with early term caesarean section\u00a0\u2013 an emerging pandemic"],"prefix":"10.1515","volume":"49","author":[{"given":"Jis","family":"Thomas","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology , Women\u2019s Wellness and Research Centre, Hamad Medical Corporation , Doha , Qatar"},{"name":"Royal College of Obstetricians and Gynecologists , Doha , Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tawa Olayemi","family":"Olukade","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s Wellness and Research Center , Doha , Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliya","family":"Naz","sequence":"additional","affiliation":[{"name":"Royal College of Obstetricians and Gynecologists , Doha , Qatar"},{"name":"Weill Cornell Medicine , Doha , Qatar"},{"name":"Sidra Medical and Research Centre , Doha , Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Husam","family":"Salama","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s Wellness and Research Center , Doha , Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"Al-Qubaisi","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s Wellness and Research Center , Doha , Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilal","family":"Al Rifai","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Women\u2019s Wellness and Research Center , Doha , Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sawsan","family":"Al-Obaidly","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Women\u2019s Wellness and Research Centre, Hamad Medical Corporation , Doha , Qatar"},{"name":"Weill Cornell Medicine , Doha , Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2021,5,7]]},"reference":[{"key":"2023040100292401206_j_jpm-2020-0402_ref_001","doi-asserted-by":"crossref","unstructured":"Ye, J, Betran, AP, Guerrero Vela, M, Souza, JP, Zhang, J. Searching for the optimal rate of medically necessary cesarean delivery. Birth 2014;41:237\u201344. https:\/\/doi.org\/10.1111\/birt.12104.","DOI":"10.1111\/birt.12104"},{"key":"2023040100292401206_j_jpm-2020-0402_ref_002","doi-asserted-by":"crossref","unstructured":"Vogel, JP, Betr\u00e1n, AP, Vindevoghel, N, Souza, JP, Torloni, MR, Zhang, J, et al.. Use of the robson classification to assess caesarean section trends in 21 countries: a secondary analysis of two WHO multicountry surveys. Lancet Global Health 2015;3:e260\u201370. https:\/\/doi.org\/10.1016\/s2214-109x(15)70094-x.","DOI":"10.1016\/S2214-109X(15)70094-X"},{"key":"2023040100292401206_j_jpm-2020-0402_ref_003","doi-asserted-by":"crossref","unstructured":"Keag, OE, Norman, JE, Stock, SJ. Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: systematic review and meta-analysis. 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