Caesareans might do more harm than good study says

Doctors have long believed that a caesarean section carries fewer risks than a vaginal delivery for premature and growth-restricted babies, but a new study has found that this approach may in fact be doing more harm than good.

Caesarean sections are routinely performed in cases where the baby has been diagnosed with intrauterine growth restriction (IUGR), and where delivery becomes necessary prior to 34 weeks gestation, on the basis that these infants would be unable to cope with the stress of a vaginal delivery.

However a study conducted at Johns Hopkins University in Baltimore has found that delivery by caesarean section in such cases is not associated with decreased incidence of complications for the infant, and in fact, those that are delivered vaginally tend to have better respiratory outcomes.

‘We found that infants delivered vaginally were not at a significantly increased risk for any neonatal complications,’ says study co-author Dr Erika Werner. ‘In fact, infants delivered by caesarean had significantly higher odds of breathing problems after birth.’

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While the study focused on premature and low-birth weight babies, the findings may also have implications for women considering an elective caesarean at full term.

Despite efforts to reduce the number of caesareans being performed in Australia, the rate has increased by more than 70% in the past 20 years, and around 1/3 of Australian babies are now delivered by caesarean section.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists is currently working with James Cook University on a study comparing health outcomes for mothers and babies following a caesarean section, but the results of this study are some years away.

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