Abstract
Objectives:
This study aimed to determine maternal and obstetric factors associated with emergency caesarean section (CS) for non-reassuring foetal status (NRFS).
Materials and methods:
This was a retrospective analysis of term singleton births between January 2007 and December 2015 at the Mater Mother’s Hospital in Brisbane. The study group comprised all cases of emergency CS for NRFS, and the control cohort comprised all other births meeting the inclusion criteria but excluding those in the study cohort.
Results:
Over the study period, there were 74,177 births fulfilling the inclusion criteria. The overall rate of emergency CS for NRFS was 4.2% (3132/74,177). Multivariate analysis showed that being overweight and obese, Indian and “other” ethnicity, artificial reproductive techniques, smoking, induction of labour and gestation at 39–42 weeks were associated with an increased risk, whereas being underweight, female sex, hypertension and birth without labour conferred a lower risk.
Conclusion:
Many maternal and obstetric factors were associated with emergency CS for NRFS and influenced adverse perinatal outcomes. Recognition of these risk factors could help risk stratify women prior to labour.
Acknowledgments
The authors acknowledge the research support given by the Mater Foundation.
Author’s statement
Conflict of interest: Authors state no conflict of interest.
Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.
Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.
References
[1] Khandelwal S, Dhanaraj M, Khandelwal A. Admission test as precursor of perinatal outcome: a prospective study. Arch Gynecol Obstet. 2010;282:377–82.10.1007/s00404-010-1406-4Search in Google Scholar
[2] Parer J, Livingston EG. What is fetal distress? Am J Obstet Gynecol. 1990;162:1421–7.10.1016/0002-9378(90)90901-ISearch in Google Scholar
[3] McIntyre S, Taitz D, Keogh J, Goldsmith S, Badawi N, Blair E. A systematic review of risk factors for cerebral palsy in children born at term in developed countries. Dev Med Child Neurol. 2013;55:499–508.10.1111/dmcn.12017Search in Google Scholar
[4] Jonsson M, Agren J, Norden-Lindeberg S, Ohlin A, Hanson U. Neonatal encephalopathy and the association to asphyxia in labor. Am J Obstet Gynecol. 2014;211:667.e1–8.10.1016/j.ajog.2014.06.027Search in Google Scholar
[5] Li Z, Zeki R, Hilder L, Sullivan E. Australia’s mothers and babies 2011. Perinatal statistics series no. 28. Cat. no. PER 59. Canberra: AIHW National Perinatal Epidemiology and Statistics Unit; 2013.Search in Google Scholar
[6] Aslam HM, Saleem S, Afzal R, Iqbal U, Saleem AM, Shaikh MW, et al. Risk factors of birth asphyxia. Ital J Pediatr. 2014;40:1–9.10.1186/s13052-014-0094-2Search in Google Scholar
[7] Low JA, Pickersgill H, Killen H, Derrick EJ. The prediction and prevention of intrapartum fetal asphyxia in term pregnancies. Am J Obstet Gynecol. 2001;184:724–30.10.1067/mob.2001.111720Search in Google Scholar
[8] Quinlan JD, Murphy NJ. Cesarean delivery: counseling issues and complication management. Am Fam Physician. 2015;91:178–84.Search in Google Scholar
[9] Grace L, Greer RM, Kumar S. Perinatal consequences of a category 1 caesarean section at term. BMJ Open. 2015;5:e007248.10.1136/bmjopen-2014-007248Search in Google Scholar
[10] Kidanto H, Msemo G, Mmbando D, Rusibamayila N, Ersdal H, Perlman J. Predisposing factors associated with stillbirth in Tanzania. Int J Gynaecol Obstet. 2015;130:70–3.10.1016/j.ijgo.2015.01.012Search in Google Scholar
[11] Zhang Q, Dunn C, Sia J, Sng B. Category one caesarean section: a team-based approach. Trends Anaes Crit Care. 2014;4:97–101.10.1016/j.tacc.2014.05.002Search in Google Scholar
[12] Pallasmaa N, Ekblad U, Aitokallio-Tallberg A, Uotila J, Raudaskoski T, Ulander VM, et al. Cesarean delivery in Finland: maternal complications and obstetric risk factors. Acta Obstet Gynecol Scand. 2010;89:896–902.10.3109/00016349.2010.487893Search in Google Scholar
[13] Foo XY, Greer RM, Kumar S. Impact of maternal body mass index on intrapartum and neonatal outcomes in Brisbane, Australia, 2007 to 2013. Birth. 2016;43:358–65.10.1111/birt.12246Search in Google Scholar
[14] Doherty DA, Magann E, Francis J, Morrison J, Newnham J. Pre-pregnancy body mass index and pregnancy outcomes. Int J Gynaecol Obstet. 2006;95:242–7.10.1016/j.ijgo.2006.06.021Search in Google Scholar
[15] Lai S, Flatley C, Kumar S. Perinatal risk factors for low and moderate five-minute Apgar scores at term. Eur J Obstet Gynecol Reprod Biol. 2017;210:251–6.10.1016/j.ejogrb.2017.01.008Search in Google Scholar
[16] Robertson L, Knight H, Prosser Snelling E, Petch E, Knight M, Cameron A, et al. Each baby counts: national quality improvement programme to reduce intrapartum-related deaths and brain injuries in term babies. Semin Fetal Neonatal Med. 2017;22:193–8.10.1016/j.siny.2017.02.001Search in Google Scholar
[17] Prior T, Mullins E, Bennett P, Kumar S. Prediction of intrapartum fetal compromise using the cerebroumbilical ratio: a prospective observational study. Am J Obstet Gynecol. 2013;208:124.e1–6.10.1016/j.ajog.2012.11.016Search in Google Scholar
[18] Khalil AA, Morales-Rosello J, Morlando M, Hannan H, Bhide A, Papageorghiou, et al. Is fetal cerebroplacental ratio an independent predictor of intrapartum fetal compromise and neonatal unit admission? Am J Obstet Gynecol. 2015;213:54.e1–10.10.1016/j.ajog.2014.10.024Search in Google Scholar
[19] Prior T, Mullins E, Bennett P, Kumar S. Umbilical venous flow rate in term fetuses: can variations in flow predict intrapartum compromise? Am J Obstet Gynecol. 2014;210:61.e1–8.10.1016/j.ajog.2013.08.042Search in Google Scholar
[20] Herraiz I, Droge LA, Gomez-Montes E, Henrich W, Galindo A, Verlohren S. Characterization of the soluble fms-like tyrosine kinase-1 to placental growth factor ratio in pregnancies complicated by fetal growth restriction. Obstet Gynecol. 2014;124:265–73.10.1097/AOG.0000000000000367Search in Google Scholar
[21] Bligh LN, Greer RM, Kumar S. The relationship between maternal placental growth factor levels and intrapartum fetal compromise. Placenta. 2016;48:63–7.10.1016/j.placenta.2016.10.007Search in Google Scholar
[22] Schifrin BS, Cohen WR. The effect of malpractice claims on the use of caesarean section. Best practice & research. Clin Obstet Gynaecol. 2013;27:269–83.10.1016/j.bpobgyn.2012.10.004Search in Google Scholar
[23] Hankins GD, Clark SM, Munn MB. Cesarean section on request at 39 weeks: impact on shoulder dystocia, fetal trauma, neonatal encephalopathy, and intrauterine fetal demise. Semin Perinatol. 2006;30:276–87.10.1053/j.semperi.2006.07.009Search in Google Scholar
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