Elective Cesarean Section Beyond ۳۹ Weeks of Gestation Decreases Prenatal Morbidities and Improve Psychomotor Development One Year After Birth

Background & Objective: This study aimed to compare the neonatal outcomes and infant development one year after birth at different gestational ages of elective cesarean section (CS) beyond ۳۸ weeks. Materials & Methods: This retrospective cohort study was recruited in an academic hospital affiliated with Tehran University of Medical Sciences between June ۲۰۱۸ and June ۲۰۲۰. The subjects of the study were the women who were scheduled for elective CS and divided into ۳ groups according to the gestational age (۳۸ ۰/۷ to ۳۸ ۶/۷ as group A, ۳۹ ۰/۷ to ۳۹ ۶/۷ as group B, and ۴۰ ۰/۷ to ۴۰ ۶/۷ as group C). The neonatal outcomes and the growth and development status were evaluated by ages and stages questionnaires® (ASQ) after ۱۲ months and compared between groups. Results: Totally, ۹۵۲ neonates were eligible for this study. In groups A, B, and C, CS was performed in ۳۱۴, ۴۰۹, and ۲۲۹ neonates, respectively. The first minute Apgar was significantly lower in the neonates with lesser gestational age at delivery (P=۰.۰۲۶). Indeed, neonatal hospitalization, hypoglycemia, and jaundice in group A were significantly higher than in other groups (P<۰.۰۰۱). Regarding psychomotor development, the scores related to gross motor and problem-solving abilities in group A were significantly lower than those in other groups (P<۰.۰۵). Conclusion: It is suggested to plan elective CS beyond ۳۹ weeks of gestation to decrease prenatal morbidities and improve psychomotor development one year after birth.

Keywords:

Elective cesarean section , Development , Gestational Age , Growth , Neonate , Morbidity