Elective cesarean section (CS) prior to the onset of labor is an established risk factor for unsuspected prematurity and subsequent morbidity from Respiratory Distress Syndrome. Extracorporeal membrane oxygenation (ECMO) centers have reported that a disproportionate number of infants requiring ECMO for the treatment of Persistent Pulmonary Hypertension of the Newborn (PPHN) were born after elective CS {Ref. Keszler M, et. al., Pediatrics 1992;89:670}. To address the question as to whether elective CS is associated with an increased risk of PPHN, a computerized perinatal database of nearly 16,000 consecutive deliveries (deliv.) [1992-1996] was analyzed. We compared the incidence of PPHN in infants born via elective CS with all others. An Odds ratio (OR) and 95% confidence intervals (CI) were calculated.

Based on our data, elective CS is associated with an almost four times higher risk of the infant subsequently developing PPHN as compared to all others. We speculate that somehow the process of labor confers some protection against the subsequent development of PPHN. Although further study is needed, this information should be considered before proceeding with an elective CS.

Results: Table

Table 1
Full size table