open access
Assessment of the birth status of children born by elective caesarean section before and after 39 weeks of gestation following in vitro fertilization
, 1, 1, 1, 1, 1, 1, 12
Affiliations- Central Clinical Hospital of the Ministry of Interior and Administration in Warsaw, Warsaw, Poland
- Center for Reproductive Health, Institute of Mother and Child, Warsaw, Poland, Poland
open access
Abstract
Objectives: Planned delivery by elective cesarean section (ECS) currently takes place after the 39th week of pregnancy, in line with current common recommendations. This is related to studies finding an overall better birth condition of newborns in the general population, and especially regarding the maturation of the lungs. Currently, there are no specific recommendations regarding cesarean section and the timing of delivery in pregnancies resulting from in vitro fertilization.
Material and methods: The collected material presents 512 mothers with children whose pregnancies were ended by caesarean section at the Department of Obstetrics, Women's Diseases and Oncological Gynecology Central Clinical Hospital of the Ministry of Internal Affairs in Warsaw in the years 2004–2016. The study group consisted of 362 mothers in pregnancies following in vitro fertilization and 150 mothers in spontaneous pregnancy, without the use of assisted reproductive technology. For the purposes of the project, only single pregnancies ending within weeks 37 to 41 of pregnancy were selected. For the purposes of our statistical and correlation analyses, having divided the pregnant women in our study group into four (elective CS delivery after IVF prior to 39 weeks, elective CS delivery after IVF after 39 weeks, elective CS delivery without the use of IVF after 39 weeks, and emergency CS delivery after IVF) we compared their data analysis of mothers and newborns results with time of delivery (weeks of gestation).
Results: The aim of this study was to assess the optimal time of an elective cesarean section at full term in an IVF pregnancy. Consistent with findings in the general population and prevailing recommendations, the expected result would be the better condition of the baby born by ECS following the 39th week of gestation. However, our statistical analysis of the collected material shows that the group delivered by ECS prior to the end of 39 weeks of pregnancy may have fewer respiratory system interventions and higher Apgar scores. Nevertheless, results lack statistical significance.
Conclusions: In conclusion these findings may indicate a need for a bigger database.
Abstract
Objectives: Planned delivery by elective cesarean section (ECS) currently takes place after the 39th week of pregnancy, in line with current common recommendations. This is related to studies finding an overall better birth condition of newborns in the general population, and especially regarding the maturation of the lungs. Currently, there are no specific recommendations regarding cesarean section and the timing of delivery in pregnancies resulting from in vitro fertilization.
Material and methods: The collected material presents 512 mothers with children whose pregnancies were ended by caesarean section at the Department of Obstetrics, Women's Diseases and Oncological Gynecology Central Clinical Hospital of the Ministry of Internal Affairs in Warsaw in the years 2004–2016. The study group consisted of 362 mothers in pregnancies following in vitro fertilization and 150 mothers in spontaneous pregnancy, without the use of assisted reproductive technology. For the purposes of the project, only single pregnancies ending within weeks 37 to 41 of pregnancy were selected. For the purposes of our statistical and correlation analyses, having divided the pregnant women in our study group into four (elective CS delivery after IVF prior to 39 weeks, elective CS delivery after IVF after 39 weeks, elective CS delivery without the use of IVF after 39 weeks, and emergency CS delivery after IVF) we compared their data analysis of mothers and newborns results with time of delivery (weeks of gestation).
Results: The aim of this study was to assess the optimal time of an elective cesarean section at full term in an IVF pregnancy. Consistent with findings in the general population and prevailing recommendations, the expected result would be the better condition of the baby born by ECS following the 39th week of gestation. However, our statistical analysis of the collected material shows that the group delivered by ECS prior to the end of 39 weeks of pregnancy may have fewer respiratory system interventions and higher Apgar scores. Nevertheless, results lack statistical significance.
Conclusions: In conclusion these findings may indicate a need for a bigger database.
Keywords
IVF; neonatal health; cesarean section
About this articleTitle
Assessment of the birth status of children born by elective caesarean section before and after 39 weeks of gestation following in vitro fertilization
Journal
Issue
Article type
Research paper
Pages
922-928
Published online
2022-12-21
Page views
408
Article views/downloads
318
DOI
Pubmed
Bibliographic record
Ginekol Pol 2023;94(11):922-928.
Keywords
IVF
neonatal health
cesarean section
Authors
Marek Pokulniewicz
Marcin Januszewski
Kamil Pluta
Alicja Jakimiuk
Tomasz Oleksik
Joanna Zytynska-Daniluk
Malgorzata Santor-Zaczynska
Artur Jakimiuk
References (15)- Sytuacja demograficzna Polski do 2017 r. Urodzenia i dzietność, Warszawa 2018, Główny Urząd Statystyczny. https://stat.gov.pl/obszary-tematyczne/ludnosc/ludnosc/sytuacja-demograficzna-polski-do-2017-roku-urodzenia-i-dzietnosc,33,1.html.
- Gleicher N, Kushnir VA, Albertini DF, et al. Improvements in IVF in women of advanced age. J Endocrinol. 2016; 230(1): F1–F6.
- Meyer R, Orvieto R, Israel A, et al. Outcomes of singleton versus twin pregnancies in the fifth and sixth decades. Eur J Obstet Gynecol Reprod Biol. 2018; 231: 255–261.
- Dayan N, Fell DB, Guo Y, et al. Severe maternal morbidity in women with high BMI in IVF and unassisted singleton pregnancies. Hum Reprod. 2018; 33(8): 1548–1556.
- Centers for Disease Control and Prevention. 2017 Assisted Reproductive Technology Fer-tility Clinic Success Rates Report. Atlanta (GA): US Dept of Health and Human Services; 2019.
- Yogev Y, Melamed N, Bardin R, et al. Pregnancy outcome at extremely advanced maternal age. Am J Obstet Gynecol. 2010; 203(6): 558.e1–558.e7.
- Osmundson S, Gould J, Butwick A, et al. Labor outcome at extremely advanced maternal age. Am J Obstet Gynecol. 2016; 214(3): 362.e1–362.e7.
- Waldenström U, Cnattingius S, Norman M, et al. Advanced maternal age and stillbirth risk in nulliparous and parous women. Obstet Gynecol. 2015; 126(2): 355–362.
- Lean SC, Derricott H, Jones RL, et al. Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis. PLoS One. 2017; 12(10): e0186287.
- Caesarean section. Clinical guideline Published: 23 November 2011. https://www.nice.org.uk/guidance/cg132/resources/caesarean-section-pdf-35109507009733.
- Wielgoś M, Bomba-Opoń D, Bręborowicz GH, et al. Rekomendacje Polskiego Towarzystwa Ginekologów i Położników dotyczące cięcia cesarskiego. Ginekologia i Perinatologia Praktyczna. 2018; 3(4): 159–174.
- Hansen AK, Wisborg K, Uldbjerg N, et al. Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study. BMJ. 2008; 336(7635): 85–87.
- Szczapa J. Podstawy neonatologii. PZWL, Warszawa 2008: 131–166.
- Paulson R. Pregnancy outcome after assisted reproductive technology. Post TW, ed. Up-ToDate. 2020. Waltham, MA: UpToDate Inc. https://www.uptodate.com.
- Magnus MC, Karlstad Ø, Parr CL, et al. Maternal history of miscarriages and measures of fertility in relation to childhood asthma. Thorax. 2019; 74(2): 106–113.
