Newborn breathing problems after a cesarean
Real, more common with planned surgery, and strongly tied to timing.
Labor squeezes fluid out of a baby's lungs and triggers hormonal changes that prepare them for air. A baby delivered before labor misses both.
In a series of 33,289 term births, combined newborn respiratory illness occurred at these rates:
| Type of birth | Respiratory problems per 1,000 births |
|---|---|
| Cesarean before labor | 35.5 |
| Cesarean during labor | 12.2 |
| Vaginal birth | 5.3 |
Within planned cesareans, earlier is worse. Delivery at 37 weeks carried 1.74 times the risk of 38 weeks, and 38 weeks carried 2.4 times the risk of 39 weeks.
Labor before a cesarean does not remove the risk entirely. In a case-control study, transient tachypnea was about equally elevated with cesarean whether or not labor had occurred.
Where this comes from:
333. Hobbs AJ, Mannion CA, McDonald SW, Brockway M, Tough SC. The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy Childbirth. 2016;16:90.
348. Silasi M, Coonrod DV, Kim M, Drachman D. Transient tachypnea of the newborn: is labor prior to cesarean delivery protective? Am J Perinatol. 2010;27(10):797-802.
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