 Respiratory risk 'link' to Caesarean choice
Source: SHÂN ROSS at scotsman.com Date: 12/12/07
BABIES born to mothers who have an elective Caesarean section are four
times more likely to suffer respiratory problems, according to new
research published today.
The findings add to the body of evidence concerning the risks linked to
the procedure - which continues to rise in popularity in the UK.
It also brings into sharp focus the debate between the "too posh to push" lobby - including celebrities such as Angelina Jolie, Britney Spears and Madonna - and those advocating natural childbirth.
In 2001, almost 25 per cent of hospital deliveries in the UK were by Caesarean section, far above
the 10-15 per cent rate recommended by the World Health Organisation.
The latest figures show that one in 11 births north of the Border involves an elective Caesarean section.
The latest study, published online by the British Medical Journal (BMJ), found babies delivered through pre-planned Caesarean sections were more likely to suffer breathing difficulties compared with those born naturally or by emergency Caesarean section. It also suggested that the earlier in the pregnancy the baby was delivered, the higher risk of problems.
The study supports previous research linking elective Caesareans with an increased risk of respiratory difficulties in new-born babies.
Although the exact reasons are unknown, researchers said factor could be that the hormonal and physiological changes associated with labour are necessary for the lungs to mature. The baby's level of development at the time of the operation may also be a factor.
Researchers from Aarhus University Hospital in Denmark carried out a study involving 34,458 babies born between 37 and 41 weeks and delivered between 1 January, 1998, and 31 December, 2006. The study included 2,687 babies born by elective Caesarean (7.8 per cent of the total).
The authors found that 2.8 per cent of infants delivered by intended vaginal delivery at 37 weeks' gestation had respiratory problems, compared with ten per cent of those delivered by elective Caesarean section.
At 38 weeks, the proportion was 1.7 per cent compared to 5.1 per cent and, at 39 weeks, 1.1 per cent compared to 2.1per cent.
The researchers wrote: "Our results suggest a significant reduction in neonatal respiratory morbidity may be obtained if elective Caesarean section is postponed to 39 weeks' gestation. This should be taken into consideration by women contemplating an elective Caesarean section and by the obstetricians counselling them."
Dr Burnett Lunan, a Glasgow-based consultant obstetrician and gynaecologist, said: "It's been known for some time that babies born electively can have problems. There is a greater risk if babies are born before term as nature decrees they are born when the lungs are ready.
"Women who have had an elective Caesarean section shouldn't panic if their child has a cold - any problems will come immediately after delivery."
'IT'S PITCHED AT PUNISHING WOMEN'
LOUISE Grant, 35, a teacher, had an elective Caesarean section at 38 weeks as her son, Frankie, now five, was in the breech position.
Mrs Grant, from Falkirk, said she had read on the internet about possible problems with the procedure, but was not warned by her consultant at the Edinburgh Royal Infirmary. "I feel this new research is pitched at punishing women who have had to have a Caesarean. We are not all celebrities and have done what was advised at the time.
"Frankie has always been healthy, with just everyday childhood illnesses like chickenpox.
"If I had a real choice and there was no risk to the baby, then I would probably think twice now because of this study."
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