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Elective repeat cesarean delivery at term typically is conducted before 39 weeks of gestation only if evidence of fetal lung maturity exists. But, even if the lungs have matured, is delivery before the 39th week associated with elevated risk for neonatal complications? To address this question, investigators studied a cohort of 13,258 consecutive women with singleton pregnancies who underwent elective cesareans at 19 U.S. centers. The primary outcome was a composite measure of neonatal mortality and morbidity, which included respiratory complications, hypoglycemia, neonatal sepsis, and neonatal intensive care unit admission.
Fully 36% of elective cesareans were performed before 39 completed weeks of gestation, and 49% were performed at 39 we…