Contrary to popular belief, cesarean section appears not to be the best way to deliver preterm babies who are small for their age, according to research presented Thursday at the annual meeting of the Society for Maternal-Fetal Medicine.
At-risk babies have traditionally been thought to benefit from c-section deliveries, but a study by researchers at Johns Hopkins and Yale Universities finds that c-sections did not lessen their odds of complications and in fact increased their likelihood of breathing problems. Compared with similar preterm babies born vaginally, infants delivered via c-section had higher rates of respiratory distress syndrome.
“These findings show not only is it not protective, but these babies have worse respiratory outcomes probably as a result of not passing through the vaginal canal and getting that compression that helps remove much of the amniotic fluid from their lungs,” says Diane Ashton, deputy medical director of the March of Dimes, which crusades against prematurity. The March of Dimes is trying to educate women that medically unnecessary c-sections — and regular inductions — should not be performed before 39 weeks.
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That’s not to say that c-sections don’t have their place. Cesarean deliveries are advised for breech babies or those whose heartrate plummets, as well as infants whose umbilical cord comes out before they do — a condition known as prolapse.
Researchers looked at birth certificate and hospital discharge papers for 2,560 small-for-gestational-age babies who were born prematurely in New York City between 1995 and 2003; 46% were delivered vaginally and 54% arrived via cesarean. They found that those babies delivered by c-section before 34 weeks of pregnancy stood a 30% greater chance of having breathing difficulties than babies born vaginally at about the same point in pregnancy.
Overall, preterm births cost the U.S. more than $26 billion each year.