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Am J Perinatol 2002; 19(2): 081-086
DOI: 10.1055/s-2002-23558
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Contribution of Elective Delivery to Severe Respiratory Distress at Term

Joseph R. Wax1 , Victor Herson3 , Eva Carignan1 , Jeffrey Mather2 , Charles J. Ingardia1
  • 1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Hartford Hospital
  • 2Department of Research, Hartford Hospital
  • 3Division of Neonatology, Connecticut Children's Medical Center, Hartford, Connecticut
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Publication Date:
02 April 2002 (online)

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ABSTRACT

We sought to determine the contribution of elective delivery to severe respiratory distress syndrome (RDS) on a weekly basis from 37-40 weeks' gestation. Chart reviews confirmed gestational age, delivery reason, and primary diagnosis of all inborn neonates with RDS requiring mechanical ventilation delivered at 37 0/7-40 6/7 weeks' gestation from 1/1/90-12/31/99. Exclusion criteria were sepsis, pneumonia, meconium aspiration, asphyxia, pulmonary hemorrhage, hydrops, chromosomal abnormality, or congenital malformations affecting respiration. Thirty-five thousand and thirty-one deliveries occurred from 37 0/7-40 6/7 weeks; 18 (0.05%) had RDS requiring mechanical ventilation. Nine infants delivered at 37 0/7-37 6/7 weeks, (OR for RDS = 38.5; 95% CI = 8.3, 178.3), seven delivered at 38 0/7-38 6/7 weeks, (OR for RDS = 13.3; 95% CI = 2.8, 64.0), and two delivered at 39 0/7-40 6/7 weeks. Six of 18 infants were electively delivered without documented lung maturity. Infants born at 37 0/7-38 6/7 weeks are at significantly increased risk for severe RDS. One third of RDS cases were potentially avoidable.

KEYWORD

Elective delivery - respiratory distress syndrome - iatrogenic prematurity

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