Severe neonatal outcomes associated with emergency cesarean section at term

Pires-Menard, Alexandra; Flatley, Christopher; Kumar, Sailesh

doi:10.1080/14767058.2019.1611770

Cited by 17 publications

(21 citation statements)

References 21 publications

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“…The upward deviation of caesarean rate than the desired range has several public health implications. The caesarean sections deliveries are found associated with post-delivery short and long term adverse health outcomes, 10 it might even increase the risks of stillbirth in the subsequent pregnancy. 15 Further, this higher prevalence of CS rates beyond optimum level (i.e., 10-15%) is not associated with decreases of maternal and neonatal mortality, 12 therefore not required to encourage CS delivery in West Bengal in the present situation.…”

Section: Discussionmentioning

confidence: 99%

“…9 Not only for mother, but the cesarean delivery has also shown a repugnant relationship with the neonatal and childhood health outcomes, including low birth weight, and obesity. 10 On the question of optimum level of caesarean rates, WHO has recommended a maximum to 15% at 'population-level' for a nation or country, 11 as beyond of which, even in the increase in cesarean rates are not associated with reductions in maternal and newborn mortality rates. 12 Nevertheless, the global rates of cesarean delivery are rising emphatically not only in developed countries but in developing countries, including India.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence and determinants of the use of caesarean section (CS) in the dichotomy of ‘public’ and ‘private’ health facilities in West Bengal. India

Sarkar

2020

Clinical Epidemiology and Global Health

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence and determinants of the use of caesarean section (CS) in the dichotomy of ‘public’ and ‘private’ health facilities in West Bengal. India

Sarkar

2020

Clinical Epidemiology and Global Health

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“…SMM is now increasingly recognized as an important obstetric care quality indicator for which WHO recommends that HICs should have appropriate surveillance measures in order to identify trends and system failures. SMM is also an important risk factor for adverse perinatal outcomes [ 10 , 11 , 12 ], although precise estimates of the magnitude of its contributory risks are unclear, despite both sharing many similar causative pathways [ 13 , 14 ]. Against this background, the aim of this systematic review and meta-analysis was to detail the impact of SMM on perinatal outcomes in HICs.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Severe Maternal Morbidity on Perinatal Outcomes in High Income Countries: Systematic Review and Meta-Analysis

Mengistu

Turner

Flatley

et al. 2020

JCM

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While there is clear evidence that severe maternal morbidity (SMM) contributes significantly to poor maternal health outcomes, limited data exist on its impact on perinatal outcomes. We undertook a systematic review and meta-analysis to ascertain the association between SMM and adverse perinatal outcomes in high-income countries (HICs). We searched for full-text publications in PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Scopus databases. Studies that reported data on the association of SMM and adverse perinatal outcomes, either as a composite or individual outcome, were included. Two authors independently assessed study eligibility, extracted data, and performed quality assessment using the Newcastle–Ottawa Scale. We used random-effects modelling to calculate odds ratios (ORs) with 95% confidence intervals. We also assessed the risk of publication bias and statistical heterogeneity using funnel plots and Higgins I2, respectively. We defined sub-groups of SMM as hemorrhagic disorders, hypertensive disorders, cardiovascular disorders, hepatic disorders, renal disorders, and thromboembolic disorders. Adverse perinatal outcome was defined as preterm birth (before 37 weeks gestation), small for gestational age (SGA) (birth weight (BW) < 10th centile for gestation), low birthweight (LBW) (BW < 2.5 kg), Apgar score < 7 at 5 min, neonatal intensive care unit (NICU) admission, stillbirth and perinatal death (stillbirth and neonatal deaths up to 28 days). A total of 35 studies consisting of 38,909,426 women were included in the final analysis. SMMs associated with obstetric hemorrhage (OR 3.42, 95% CI: 2.55–4.58), severe hypertensive disorders (OR 6.79, 95% CI: 6.06–7.60), hepatic (OR 3.19, 95% CI: 2.46–4.13) and thromboembolic disorders (OR 2.40, 95% CI: 1.67–3.46) were significantly associated with preterm birth. SMMs from hypertensive disorders (OR 2.86, 95% CI: 2.51–3.25) or thromboembolic disorders (OR 1.48, 95% CI: 1.09–1.99) were associated with greater odds of having SGA infant. Women with severe hemorrhage had increased odds of LBW infant (OR 2.31, 95% CI: 1.57–3.40). SMMs from obstetric hemorrhage (OR 4.16, 95% CI: 2.54–6.81) or hypertensive disorders (OR 4.61, 95% CI: 1.17–18.20) were associated with an increased odds of low 5-min Apgar score and NICU admission (Severe obstetric hemorrhage: OR 3.34, 95% CI: 2.26–4.94 and hypertensive disorders: OR 3.63, 95% CI: 2.63–5.02, respectively). Overall, women with SMM were 4 times more likely to experience stillbirth (OR 3.98, 95% CI: 3.12–7.60) compared to those without SMM with cardiovascular disease (OR 15.2, 95% CI: 1.29–180.60) and thromboembolic disorders (OR 9.43, 95% CI: 4.38–20.29) conferring greatest risk of this complication. The odds of neonatal death were significantly higher in women with SMM (OR 3.98, 95% CI: 2.44–6.47), with those experiencing hemorrhagic (OR 7.33, 95% CI: 3.06–17.53) and hypertensive complications (OR 3.0, 95% CI: 1.78–5.07) at highest risk. Overall, SMM was also associated with higher odds of perinatal death (OR 4.74, 95% CI: 2.47–9.12) mainly driven by the increased risk in women experiencing severe obstetric hemorrhage (OR 6.18, 95% CI: 2.55–14.96). Our results highlight the importance of mitigating the impact of SMM not only to improve maternal health but also to ameliorate its consequences on perinatal outcomes.

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“…Nonreassuring fetal status often requires performance of emergency cesarean section and leads to preterm birth. [3][4][5][6][7] It is associated with approximately 10% of primary cesareans in the United States (US). [8] Preterm birth, which is highly associated with an increased risk of neonatal morbidity and mortality, has become a global health issue in obstetrics.…”

Section: Introductionmentioning

confidence: 99%

“…However, little is known about its association with nonreassuring fetal status. Given that nonreassuring fetal status in the late stage of pregnancy often leads to preterm birth, [3][4][5][6][7] it is important to further investigate whether tocolytic treatment for preterm uterine contraction is associated with an increased risk of nonreassuring fetal status. Therefore, the purpose of this study was to evaluate the association between tocolysis for preterm uterine contraction and the risk of nonreassuring fetal status.…”

Section: Introductionmentioning

confidence: 99%

Tocolysis and the risk of nonreassuring fetal status among pregnant women in labor

Wang

Tsai²,

Erickson

et al. 2019

Medicine

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The purpose of this study was to evaluate the association between tocolysis for preterm uterine contraction and the risk of nonreassuring fetal status.This was a retrospective cohort study using data from the Taiwan National Health Insurance Research Database. Pregnant women were enrolled if they delivered a baby during January 1, 2003 to December 31, 2011. The occurrence of the nonreassuring fetal status was compared between pregnant women with and without tocolytic treatment for preterm uterine contraction. Multivariable logistic regression models with adjusted cofounders were used to evaluate the association between tocolysis and the risk of nonreassuring fetal status.Of 24,133 pregnant women, 1115 (4.6%) received tocolytic treatment during pregnancy. After adjusting for covariates, pregnant women receiving tocolysis more than one time during pregnancy were found to have significantly higher risk of the nonreassuring fetal status when compared with pregnant women who did not receive tocolysis for uterine contraction (Odds Ratio = 2.70, 95% Confidence Interval: 1.13-6.49).Pregnant women with more frequent tocolysis for preterm uterine contraction during pregnancy had an increased risk of nonreassuring fetal status. Close evaluation of dose and duration of tocolytic treatment is necessary for pregnant women with preterm uterine contraction.

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Severe neonatal outcomes associated with emergency cesarean section at term

Cited by 17 publications

References 21 publications

Prevalence and determinants of the use of caesarean section (CS) in the dichotomy of ‘public’ and ‘private’ health facilities in West Bengal. India

Prevalence and determinants of the use of caesarean section (CS) in the dichotomy of ‘public’ and ‘private’ health facilities in West Bengal. India

The Impact of Severe Maternal Morbidity on Perinatal Outcomes in High Income Countries: Systematic Review and Meta-Analysis

Tocolysis and the risk of nonreassuring fetal status among pregnant women in labor

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