Comparison of Maternal and Neonatal Outcome Following Cesarean Section at 38-40 Weeks

Document Type : Original Article


1 Maternal, Fetal, and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Obstetrics and Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Neonatology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran


Background: The rate of Cesarean section is increasing which may be due to maternal and neonatal issues. Preterm Cesarean (at 38-39 weeks) has several morbidities and leads to maternal problems. The goal of this study was to compare neonatal and maternal complications following the performance of the Cesarean section after 38 weeks.
Methods: This cross-sectional study evaluated 1010 subjects with term Cesarean section that referred to Yas hospital, in Tehran, Iran during 2015-7. The participants were divided into three groups based on the week of delivery. Afterward, they were studied for different neonatal and maternal complications.
Results: According to the findings, the risk of adverse neonatal outcomes had a statistically negative relationship with the progress of gestational age. Moreover, the rate of hypoglycemia and hyperbilirubinemia and stillbirth was higher in neonates delivered before 38 weeks. Among the maternal complications, the rate of massive bleeding during cesarean section or in the postpartum period was significantly higher in deliveries before 39 weeks, whereas the rate of pelvic infection was higher in deliveries after 40 weeks.
Conclusion: Based on the results of this study, the best time for the Cesarean section is the 39th week of pregnancy which led to the elimination of maternal and neonatal complications.


1. World Health Organization, World Health Organization. Nutrition for Health. WHO child growth standards: growth velocity based on weight, length and head circumference: methods and development. Geneva: World Health Organization; 2009.
2. Spong CY, Mercer BM, D’Alton M, Kilpatrick S, Blackwell S, Saade G. Timing of indicated late-preterm and early-term birth. Obstet Gynecol. 2011; 118(2 Pt 1):323-33.
3. Wen SW, Smith G, Yang Q, Walker M. Epidemiology of preterm birth and neonatal outcome. Semin Fetal Neonatal Med. 2004; 9(6):429-35.
4. Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010; 88(1):31-8.
5. Lindström K. Long-term consequences of preterm birth: swedish national cohort studies. Södersju-khuset: Department of Clinical Science and Education; 2011.
6. Flood K, Malone FD. Prevention of preterm birth. Semin Fetal Neonatal Med. 2012;17(1):58-63.
7. Aarnoudse-Moens CS, Weisglas-Kuperus N, van Goudoever JB, Oosterlaan J. Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children. Pediatrics. 2009; 124(2):717-28.
8. Ward RM, Beachy JC. Neonatal complications following preterm birth. BJOG. 2003; 110(Suppl 20):8-16.
9. Engle WA, Kominiarek MA. Late preterm infants, early term infants, and timing of elective deliveries. Clin Perinatol. 2008; 35(2):325-41.
10. Bastek JA, Sammel MD, Paré E, Srinivas SK, Posencheg MA, Elovitz MA. Adverse neonatal outcomes: examining the risks between preterm, late preterm, and term infants. Am J Obstet Gynecol. 2008; 199(4):367.e1-8.
11. Raju TN, Higgins RD, Stark AR, Leveno KJ. Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the National Institute of Child Health
and Human Development. Pediatrics. 2006; 118(3): 1207-14.
12. Swamy GK, Ostbye T, Skjaerven R. Association of preterm birth with long-term survival, reproduction, and next-generation preterm birth. JAMA. 2008; 299(12):1429-36.
13. Bailit JL, Gregory KD, Reddy UM, Gonzalez-Quintero VH, Hibbard JU, Ramirez MM, et al. Maternal and neonatal outcomes by labor onset type and gestational age. Am J Obstet Gynecol. 2010; 202(3):245.e1-12.
14. Houweling LM, Bezemer ID, Penning-van Beest FJ, Meijer WM, van Lingen RA, Herings RM. First year of life medication use and hospital admission rates: premature compared with term infants. J Pediatr. 2013; 163(1):61-6.e1.
15. Tita AT, Landon MB, Spong CY, Lai Y, Leveno KJ, Varner MW, et al. Timing of elective repeat cesarean delivery at term and neonatal outcomes. New Engl J Med. 2009; 360(2):111-20.
16. Wilmink FA, Hukkelhoven CW, Lunshof S, Mol BW, van der Post JA, Papatsonis DN. Neonatal outcome following elective cesarean section beyond 37 weeks of gestation: a 7-year retrospective analysis of a national registry. Am J Obstet Gynecol. 2010; 202(3):250.e1-8.
17. Signore C, Klebanoff M. Neonatal morbidity and mortality after elective cesarean delivery. Clin Perinatol. 2008; 35(2):361-71.
18. Murphy VE, Smith R, Giles WB, Clifton VL. Endocrine regulation of human fetal growth: the role of the mother, placenta, and fetus. Endocr Rev. 2006; 27(2):141-69.
19. Laopaiboon M, Lumbiganon P, Intarut N, Mori R, Ganchimeg T, Vogel J, et al. Advanced maternal age and pregnancy outcomes: a multicountry assessment. BJOG. 2014; 121(Suupl 1):49-56.
20. Somboonviboon W, Kyokong O, Charuluxananan S, Narasethakamol A. Incidence and risk factors of hypotension and bradycardia after spinal anesthesia for cesarean section. J Med Assoc Thai. 2008; 91(2):181-7.
21. Hansen AK, Wisborg K, Uldbjerg N, Henriksen TB. Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study. BMJ. 2008; 336(7635):85-7.
22. Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A, et al. Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet. 2006; 367(9525):1819-29.