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In the U.S., women who have already had one cesarean delivery have >90% likelihood of repeat cesarean delivery. In a retrospective cohort study, investigators assessed neonatal outcomes and costs of elective repeat cesarean delivery compared with vaginal birth after cesarean (VBAC) from October 2005 to July 2008 at one academic hospital. In all, 343 women (51%) planned to have an elective cesarean delivery (intended-cesarean group) and 329 (49%) planned trials of labor (VBAC group). The primary outcome was admission to the newborn intensive care unit (NICU).
Rates of NICU admission were 9% for infants born by elective cesarean delivery and 5% for those born by VBAC. Neonates in the intended-cesarean group were more likely to require oxygen s…