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

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.