Perinatal outcomes of term cesarean sections: A retrospective study in Northern Greece

Introduction: Cesarian section rates are increasing globally, creating a possible risk factor for adverse neonatal outcomes. The present study aimed to investigate the optimal timing for elective cesarean section in pregnant women with a history of prior cesarean with regards to neonatal outcomes. Material and Methods: A retrospective observational study (2017-2023) was conducted at the Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece. All cases of cesarean section, due to a previous cesarean, after 37+0 gestational weeks from and the neonatal outcomes were retrieved. Results: In total, 829 cases of term cesarean sections were documented in women with a history of prior cesarean. From these, 51.1% delivered at 37+0 – 38+6 weeks, while 48.9% >39+0 weeks onwards. Neonates born >39+0 weeks showed higher 5-minute Apgar score (8.93 vs 8.89; p=0.03) and higher birthweight (3,402g vs 3,235g; p<0.001) compared to neonates born prior to 39 weeks. Additionally, there was an increased risk of cesarean section when labor was planned after 39 gestational weeks (p<0.001), due to onset of labor, initiation of contractions or rupture of membranes, posing a higher risk on adverse neonatal events. Conclusion: Cesarean section >39+0 weeks was associated with better neonatal outcomes, so this policy should be adopted by all perinatal centers.