Elective Repeat Cesarean Delivery at Term: What Timing Is Best?

Unless fetal lung maturity has been confirmed, elective cesarean delivery (CD) before 39 weeks’ gestation is associated with excess risk for neonatal respiratory problems. In an observational study at 19 U.S. centers, infants of women who underwent elective CD from 1999 to 2002 at ≥37 weeks’ gestation were assessed for a primary composite outcome that included any of several events (e.g., death, respiratory-distress syndrome, transient tachypnea of the newborn, hypoglycemia, newborn sepsis, cardiopulmonary resuscitation or ventilator support within 24 hours of birth, 5-minute Apgar scores ≤3).

Of 13,258 term elective repeat CDs, 35.8% were performed before 39 weeks’ gestation. Women who delivered before 39 weeks were more likely than those w…