Elective Cesarean Section Beyond 39 Weeks of Gestation Decreases Prenatal Morbidities and Improve Psychomotor Development One Year After Birth

This study aimed to compare the neonatal outcomes and infant development one year after birth at different gestational ages of elective cesarean section (CS) beyond 38 weeks.

This retrospective cohort study was recruited in an academic hospital affiliated with Tehran University of Medical Sciences between June 2018 and June 2020. The subjects of the study were the women who were scheduled for elective CS and divided into 3 groups according to the gestational age (38 0/7 to 38 6/7 as group A, 39 0/7 to 39 6/7 as group B, and 40 0/7 to 40 6/7 as group C). The neonatal outcomes and the growth and development status were evaluated by ages and stages questionnaires® (ASQ) after 12 months and compared between groups.

Totally, 952 neonates were eligible for this study. In groups A, B, and C, CS was performed in 314, 409, and 229 neonates, respectively. The first minute Apgar was significantly lower in the neonates with lesser gestational age at delivery (P=0.026). Indeed, neonatal hospitalization, hypoglycemia, and jaundice in group A were significantly higher than in other groups (P<0.001). Regarding psychomotor development, the scores related to gross motor and problem-solving abilities in group A were significantly lower than those in other groups (P<0.05).

It is suggested to plan elective CS beyond 39 weeks of gestation to decrease prenatal morbidities and improve psychomotor development one year after birth.