Birth weight-specific fetal deaths and neonatal mortality and the rising cesarean section rate
Sepkowitz, S.
Journal of the Oklahoma State Medical Association 85(5): 236-241
1992
ISSN/ISBN: 0030-1876 PMID: 1512646 Document Number: 396983
To address the question of what effect the rising cesarean section rate has on fetal and neonatal mortality, 33,843 births and 4,132 sections were studied at a community hospital (1968-1987). Crude fetal and neonatal mortality rates declined as the annual section rate rose from 4.7% to 25.7%. However, weight-specific mortality rates bore little relationship to weight-specific section rates. Neonatal mortality rates for infants weighing over 2499 g and without congenital anomalies remained essentially the same (.91, 1.0, 1.02 per 1000 live births) for each of the five-year periods included in the study, despite marked increases in section rates. Among fetal deaths in this weight group, only antepartum deaths declined in each period. This analysis of birth weight-specific mortality indicates that a five-fold rise in the annual cesarean section rate has contributed little, if anything, to reductions in fetal and neonatal mortality during this time.