Timing of Planned Cesarean Delivery by Racial Group

Balchin, Imelda; Whittaker, John C.; Lamont, Ronald F.; Steer, Philip

doi:10.1097/aog.0b013e318163cd55

Cited by 33 publications

(26 citation statements)

References 27 publications

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“…26 In support of variation in the rate of fetal maturity, it is known that black and South Asian neonates born preterm suffer less respiratory distress syndrome compared with white neonates of the same gestational age, with similar observations in female compared with male neonates. 5,[27][28][29] Furthermore, there are several reports of a shorter gestational length in blacks and South Asians compared with white pregnancies. 6,30,31 This suggests early maturation of the fetoplacental unit.…”

Section: Discussionmentioning

confidence: 94%

“…33 Furthermore, the presence of meconium-stained AF alone independently increases the risk of neonatal respiratory morbidity. 5 Other significant predictors of meconium-stained AF include malpresentation or vaginal breech delivery. Because perinatal mortality rate is known to be higher in this group, fetal hypoxia is the likely explanation for the increased rate of meconium-stained AF.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8] Meconium (fetal colonic contents) is usually passed after birth, and the mechanisms underlying passage before birth are unknown. Meconiumstained AF is uncommon in preterm births (occurring in about 5%) but occurs more frequently with advancing gestational age.…”

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confidence: 99%

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Maternal and Fetal Characteristics Associated With Meconium-Stained Amniotic Fluid

Balchin

Whittaker

Lamont

et al. 2011

Obstetrics &Amp; Gynecology

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Maternal and Fetal Characteristics Associated With Meconium-Stained Amniotic Fluid

Balchin

Whittaker

Lamont

et al. 2011

Obstetrics &Amp; Gynecology

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“…Thus, the results may apply to women with a non-medical reason for a planned caesarean section and to women with an indicated caesarean section where timing prior to 39 weeks and five days would not be indicated [24]. Since nearly 95% of the women in this trial were white Europeans, scheduling caesarean section after 39 weeks may carry a larger risk of having an unscheduled procedure in populations with different ethnicities [25]. …”

Section: Discussionmentioning

confidence: 99%

Randomised Trial of Planned Caesarean Section Prior to Versus after 39 Weeks: Unscheduled Deliveries and Facility Logistics - A Secondary Analysis

et al. 2013

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ObjectivesTo compare the impact of scheduling caesarean section prior to versus after 39 completed weeks of gestation on the occurrence of unscheduled caesarean section and rescheduling of the procedure. MethodsSecondary analysis from a multicentre randomised open-label trial including singleton pregnant women with a healthy foetus and a reliable due date. Women were allocated by computerized telephone randomisation to planned caesarean section at 38 weeks and three days or 39 weeks and three days. The outcomes were unscheduled deliveries with provided reasons, such as spontaneous labour onset or supervening complications, and any changes in the scheduled delivery date. Statistical analyses were according to intention-to-treat using Fisher’s exact test.ResultsFrom March 2009 to June 2011 1,274 women were included. Median difference in gestational age at delivery was six days. Compared to the 38 weeks group, the women in the 39 weeks group were more likely to have an unscheduled caesarean section (15.2% vs. 9.3%; RR 1.64, 95% CI 1.21; 2.22), to deliver between 6 pm and 8 am (10 % vs. 6%; RR 1.68, 95% CI 1.14; 2.47), or to have the procedure rescheduled (36.7% vs. 23%; RR 1.6, 95% CI 1.34;1.90). ConclusionsScheduling caesarean section after 39 weeks leads to a 60% increase in unscheduled caesarean sections and a 70% increase in delivery outside regular work hours as compared to scheduling of the procedure prior to 39 weeks. Trial Registration www.clinicaltrials.gov NCT00835003 http://www.clinicaltrials.gov/ct2/show/NCT00835003?term=NCT00835003&rank=1

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“…Perinatal mortality and morbidity are significantly higher in babies born at extremes of gestation, because of the complications of prematurity or postmaturity. 1,2 In addition, the correct allocation of gestational age is important for perinatal management; for example, balancing the risk of continuing the pregnancy with the risk of delivery. 3,4 In 2004, we studied 497 105 pregnancies booked at 15 maternity units in North West London and reported a preterm birth rate of 7.6% (95% CI 7.5-7.7).…”

Section: Introductionmentioning

confidence: 99%

The effect of exclusion of cases with unrecorded best estimate of gestational age on the estimates of preterm birth rate

Balchin¹,

Whittaker²,

Lamont³

et al. 2009

BJOG

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Objectives To investigate the effect of excluding cases with unrecorded best estimate of gestational age at birth on pregnancy outcome reporting and to determine the reasons for unrecorded gestational age data. Design Prospective study. Setting Fifteen maternity units in North West London. Population 497 105 women who booked for antenatal care from 1988 to 1998. Method Multiple logistic regression analysis. Main outcome measures Preterm birth rate of, and the factors associated with, cases with unrecorded best estimate of gestational age at birth. Results Of the 53 981 cases with an unrecorded best estimate of gestational age at birth, by using additional data, it was possible to compute a new best estimate of gestational age in 80%. In this latter group, the preterm birth rate was 42% (95% CI 41.5–42.6). The corrected, overall preterm birth rate in North West London (9.8%, 9.7–9.9) was higher than the original estimate (7.6%, 7.5–7.7), which included only cases with recorded data on gestational age at birth. The most significant factors associated with an unrecorded gestational age were no ultrasound scan (OR 49, P < 0.001), and preterm birth <31 weeks (OR 30, P < 0.001). Conclusions The incidence of preterm birth are likely to be under‐reported in studies where only cases with readily available gestational age data are included. In routinely collected maternity data, human omission is an important contributing factor for an unrecorded best estimate of gestational age at birth. This is associated with the urgent transfer of babies to the neonatal intensive care unit.

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Timing of Planned Cesarean Delivery by Racial Group

Cited by 33 publications

References 27 publications

Maternal and Fetal Characteristics Associated With Meconium-Stained Amniotic Fluid

Maternal and Fetal Characteristics Associated With Meconium-Stained Amniotic Fluid

Randomised Trial of Planned Caesarean Section Prior to Versus after 39 Weeks: Unscheduled Deliveries and Facility Logistics - A Secondary Analysis

The effect of exclusion of cases with unrecorded best estimate of gestational age on the estimates of preterm birth rate

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