# Optimal Timing for Elective Cesarean Deliveries: Insights from a Comparative Study at 38- or 39-Weeks Gestation: Elective Cesarean Delivery at 38 vs 39 Weeks

## TL;DR

A study compares elective cesarean deliveries at 38 vs 39 weeks gestation, finding more maternal complications at 38 weeks but similar overall outcomes.

## Contribution

The study provides new evidence on maternal and neonatal outcomes of elective cesarean deliveries at 38 versus 39 weeks gestation.

## Key findings

- Maternal complications like infection and uterine rupture were higher at 38 weeks.
- Neonates born at 39 weeks had higher length and weight.
- Most maternal and neonatal outcomes were similar between the two groups.

## Abstract

Background: The optimal timing for elective cesarean deliveries remains a
subject of debate, with concerns regarding consequences for mother and child
at different gestational ages.

Materials and Methods: This prospective cohort study was done in 2022 at
hospitals associated with Shiraz University of Medical Sciences. Singleton
pregnant women whose pregnancies were terminated at 38(38+0 to 38+6) or 39
(39+0 to 39+6) weeks gestation were enrolled. Data on demographic
characteristics, maternal and neonatal outcomes, and complications were
collected from hospital records. The maternal and neonatal pregnancy
outcomes were compared between the two groups using SPSS version 21. T-test,
Mann–Whitney U test, Chi-square test, and Fisher’s exact test were
performed.

Results: Among 1812 cesarean deliveries, 1274 (70.3%) were performed at 38
weeks gestational age and 538 (29.7%) at 39 weeks gestational age. Maternal
complications, including infection at the surgical site (1.6% vs 0.4%,
P=0.03) and uterine rupture( 0.6% vs 0, P=0.04), were more prevalent in the
38-week group. Growth indices were higher in neonates born at 39 weeks
(length 49.55±2.36 vs 48.71±2.05 cm P=0.001 & weight 3.57±0.67 vs
3.37±0.59
kg P=0.001). No significant differences were observed in other maternal or
neonatal complications between the two groups.

Conclusion: Deliveries at 38 weeks were associated with a higher rate of
maternal complications, possibly due to their emergent nature. However,
there were no significant differences in most maternal and neonatal
outcomes. Elective cesarean at 38 weeks may still be reasonable to avoid
emergency operations and their risks.