Cesarean delivery and respiratory distress syndrome: Does labor make a difference?

• Published in: American journal of obstetrics and gynecology 2005-09, Vol.193 (3), p.1061-1064
• Main Authors: Gerten, Kim A., Coonrod, Dean V., Bay, R. Curtis, Chambliss, Linda R.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Case-Control Studies; Cesarean Section; Confounding Factors (Epidemiology); Delivery. Postpartum. Lactation; Elective Surgical Procedures; Female; Fetal Organ Maturity; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Labor; Labor, Obstetric; Lung - embryology; Medical sciences; Mode of delivery; Pneumology; Pregnancy; Respiratory distress syndrome; Respiratory Distress Syndrome, Newborn - epidemiology; Respiratory system : syndromes and miscellaneous diseases; Trial of Labor
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2005.05.038

The purpose of this study was to determine if cesarean delivery is a risk factor for respiratory distress syndrome (RDS) and if this risk is modified by labor before cesarean. This population-based case-control study compared 4778 cases of RDS to 5 times as many controls. Unadjusted, cesarean delivery was associated with RDS, odds ratio (OR) 3.5 (95% CI 3.2–3.8). After controlling for potential confounding variables, cesarean remained an independent risk factor, OR 2.3 (95% CI 2.1–2.6). Labor modified this risk significantly ( P = .02)—with labor, cesarean delivery had an OR of 1.9 (95% CI 2.2–2.9), without labor, the OR was 2.6 (95% CI 1.3–2.8). Cesarean delivery was an independent risk factor for RDS. The risk was reduced with labor before cesarean, but still elevated. This supports the importance of being certain of fetal lung maturity before cesarean delivery, particularly when done before labor.