抄録
Background: It is suggested that antenatal corticosteroid administration (ACS) to women at risk for late preterm birth reduces neonatal respiratory complications. However, ACS to pregnant women at risk in late preterm is still not recommended in Japan due to concerns about the long-term prognosis of their children. We aimed to assess the late preterm neonatal respiratory morbidity risk from singleton cesarean delivery before labor without ACS in pregnancy.
Methods: We retrospectively reviewed and analyzed data from the records of singleton cesarean deliveries of late preterm infants. The prevalence of neonatal respiratory morbidities necessitating ventilatory support such as continuous positive airway pressure or mechanical ventilation was compared with gestational age in late preterm. Respiratory distress syndrome (RDS) in the neonates was also compared.
Results: One hundred singleton cesarean deliveries in the late preterm period were eligible for inclusion: 22 neonates were delivered at 34 weeks, 34 at 35 weeks, and 44 at 36 weeks. There was a significant difference in respiratory morbidity that decreased significantly with gestational age (p < 0.001). Similarly, there was a significant difference in RDS, and the most frequent was at 34 weeks (18.2 %, p = 0.017). There were no cases of RDS at 36 weeks.
Conclusion: Late preterm birth via cesarean delivery before labor without ACS, especially at 34 and 35 weeks, was associated with the need for ventilation. Treatment with ACS in elective cesarean section with the risk of preterm delivery before 35 weeks and 6 days might be allowed.
