Cesarean section. Risk and benefits for mother and fetus

Abstract

Effects of cesarean section on neonatal mortality for breech infants and low-birth-weight vertex infants were studied by using data from the Georgia [USA] neonatal surveillance network on 392,241 singleton [human] deliveries between 1974 and 1978. Risk of neonatal death for breech infants weighing 4000 g or less delivered vaginally was significantly higher than the risk of those delivered by cesarean section. The lower the birth weight, the higher the risk for a vaginal breech delivery. For breech infants weighing 1000-2500 g, the risk was almost 21/2 times greater for a vaginal delivery vs. cesarean delivery. The best outcome for high-risk vertex infants weighing 1000-1500 g was for these delivered by ceasrean section in a tertiary perinatal center. An increase in the cesarean section rate may be associated with increased neonatal survival but, the benefits must be weighed against the costs of an increased maternal mortality and morbidity.