Impact of antenatal oxytocin infusion on neonatal respiratory morbidity associated with elective cesarean section

Introduction This study was designed to estimate respiratory morbidity associated with elective cesarean section (ECS) and to determine the effect of antenatal oxytocin exposure on this morbidity. Material and methods Nine hundred and sixty-five neonates ≥ 37 weeks’ gestation delivered by cesarean section during 1 year were included in this retrospective study and classified into two groups according to oxytocin exposure before cesarean deliveries. Respiratory morbidity for each group was recorded and statistically analyzed. Results Transient tachypnea of newborn (TTN) was significantly more frequent in group II (ECS group) than in group I (cesarean section after oxytocin exposure) (8.19% vs. 2.92%; respectively, p = 0.0006). Mechanical ventilation, continuous positive airway pressure (CPAP) and oxygen therapy were significantly more frequent in group II than in group I (1.78%, 2.14% and 4.28% versus 0.44%, 0.58% and 1.46%, respectively; p = 0.039, and p = 0.033 and p = 0.009, respectively). The number of newborns admitted to the neonatal unit and neonatal intensive care unit (NICU) was significantly higher in group II than in group I (6.41% and 2.14% vs. 2.05% and 0.58%, respectively; p = 0.001 and p = 0.033, respectively). Surfactant, fluid therapies and parenteral nutrition were significantly more frequent in group II than in group I (2.14%, 4.28% and 2.49% vs. 0.15%, 1.46% and 0.73%, respectively; p = 0.001, p = 0.009 and p = 0.02, respectively). Conclusions Neonatal respiratory morbidity associated with ECS significantly decreased after antenatal oxytocin exposure. A significant reduction of neonatal respiratory morbidity would be achieved if ECS were performed after 39 weeks’ gestation.

[1]  Y. Al-Worafi,et al.  Empirical use of antibiotic therapy in the prevention of early onset sepsis in neonates: a pilot study , 2015, Archives of medical science : AMS.

[2]  F. Goffinet,et al.  Stabilising the caesarean rate: which target population? , 2015, BJOG : an international journal of obstetrics and gynaecology.

[3]  M. Torloni,et al.  A Systematic Review of the Robson Classification for Caesarean Section: What Works, Doesn't Work and How to Improve It , 2014, PloS one.

[4]  Ramadevi Wani,et al.  Emergency Peripartum Hysterectomy: A 13-Year Review at a Tertiary Center in Kuwait , 2014, The Journal of Obstetrics and Gynecology of India.

[5]  M. Merialdi,et al.  Do Italian women prefer cesarean section? Results from a survey on mode of delivery preferences , 2013, BMC Pregnancy and Childbirth.

[6]  A. Kurylak,et al.  Healthcare-associated infections in a neonatal intensive care unit , 2012, Archives of medical science : AMS.

[7]  J. Belizán,et al.  [Rates of caesarean sections tn two types of private hospitals: restriced-access and open-access]. , 2012, Ginecologia y obstetricia de Mexico.

[8]  A. Jonguitud Aguilar [Elective caesarean: impact of evolution neonatal respiration]. , 2011, Ginecologia y obstetricia de Mexico.

[9]  B. Hamilton,et al.  Recent trends in cesarean delivery in the United States. , 2010, NCHS data brief.

[10]  L. Jain,et al.  Elective cesarean section: its impact on neonatal respiratory outcome. , 2008, Clinics in perinatology.

[11]  F. Menacker,et al.  Neonatal mortality for primary cesarean and vaginal births to low-risk women: application of an "intention-to-treat" model. , 2008, Birth.

[12]  P. Sagot,et al.  Severe respiratory disorders in term neonates. , 2007, Paediatric and perinatal epidemiology.

[13]  N. Uldbjerg,et al.  Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study , 2007, BMJ : British Medical Journal.

[14]  M. ROTH-KLEINER,et al.  Increasing incidence of respiratory distress in neonates , 2007, Acta paediatrica.

[15]  A. Donner,et al.  Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study , 2007, BMJ : British Medical Journal.

[16]  H. Hardardóttir,et al.  [Respiratory dysfunction in infants born by elective cesarean section without labor]. , 2007, Laeknabladid.

[17]  N. Uldbjerg,et al.  Elective caesarean section and respiratory morbidity in the term and near‐term neonate , 2007, Acta obstetricia et gynecologica Scandinavica.

[18]  M. Heaman Infant and Neonatal Mortality for Primary Cesarean and Vaginal Births to Women With “No Indicated Risk,” United States, 1998–2001 Birth Cohorts , 2007 .

[19]  A. Ferrante,et al.  The influence of timing of elective cesarean section on risk of neonatal pneumothorax. , 2007, The Journal of pediatrics.

[20]  C. Pettker,et al.  Neonatal mortality for low-risk women by method of delivery. , 2007, Birth.

[21]  D. Creedy,et al.  Elective cesarean section and decision making: a critical review of the literature. , 2007, Birth.

[22]  S. Nilsen,et al.  Planned cesarean versus planned vaginal delivery at term: comparison of newborn infant outcomes. , 2006, American journal of obstetrics and gynecology.

[23]  M. Ross,et al.  Cesarean section and transient tachypnea of the newborn. , 2006, American journal of obstetrics and gynecology.

[24]  L. Jain,et al.  Respiratory transition in infants delivered by cesarean section. , 2006, Seminars in perinatology.

[25]  F. Menacker,et al.  Cesarean delivery: background, trends, and epidemiology. , 2006, Seminars in perinatology.

[26]  S. Dollberg,et al.  Neonatal respiratory morbidity after elective cesarean section , 2006, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[27]  A. Riskin,et al.  Cesarean section, gestational age, and transient tachypnea of the newborn: timing is the key. , 2005, American journal of perinatology.

[28]  F. Alderdice,et al.  Admission to neonatal intensive care with respiratory morbidity following 'term' elective caesarean section. , 2005, Irish medical journal.

[29]  R. Clark The Epidemiology of Respiratory Failure in Neonates Born at an Estimated Gestational Age of 34 Weeks or More , 2005, Journal of Perinatology.

[30]  L. Chambliss,et al.  Cesarean delivery and respiratory distress syndrome: does labor make a difference? , 2004, American journal of obstetrics and gynecology.

[31]  B. Richardson,et al.  The impact of labor at term on measures of neonatal outcome. , 2005, American journal of obstetrics and gynecology.

[32]  V. Zanardo,et al.  Neonatal respiratory morbidity risk and mode of delivery at term: influence of timing of elective caesarean delivery , 2004, Acta paediatrica.

[33]  E. Lieberman,et al.  Neonatal outcome after trial of labor compared with elective repeat cesarean section. , 2003, Birth.

[34]  M. ROTH-KLEINER,et al.  Respiratory distress syndrome in near-term babies after caesarean section. , 2003, Swiss medical weekly.

[35]  R. Bland,et al.  Loss of liquid from the lung lumen in labor: more than a simple "squeeze". , 2001, American journal of physiology. Lung cellular and molecular physiology.

[36]  L. Jain,et al.  Expression of highly selective sodium channels in alveolar type II cells is determined by culture conditions. , 2001, American journal of physiology. Lung cellular and molecular physiology.

[37]  R. Bland,et al.  Lung epithelial ion transport and fluid movement during the perinatal period. , 1990, The American journal of physiology.