Neonatal and Neurodevelopmental Outcomes Following Category 1 Cesarean Section in a Japanese Tertiary Perinatal Center
Yuka Sano Wada, Yuka Shibata, Sayaka Hayashi, Risa Arai, Masaki Sato, Yoko Yamashita, Nagayoshi Umehara, Yushi Ito, Tetsuya Isayama, Seiji Wada, Haruhiko SagoABSTRACT
Aim
To elucidate the neonatal and neurodevelopmental outcomes of infants born via Category 1 cesarean section (CS) in a Japanese tertiary perinatal center.
Methods
Infants born via Category 1 CS from 2015 to 2019 at the National Center for Child Health and Development were included. Neonatal outcomes, including intrapartum/infant death, cord blood pH, and Apgar scores, and neurodevelopmental outcomes assessed using the Kinder Infant Development Scale (KIDS) were examined.
Results
A total of 101 children from 95 mothers were evaluated. The median decision‐to‐delivery interval (DDI) was 16 min. No intrapartum deaths occurred. Three children died during the neonatal period, whereas one died at 5 years of age. Among those who died, two had congenital diaphragmatic hernia, whereas two were preterm. The mean cord blood pH was 7.22; the median Apgar scores were 8 and 9, at 1 and 5 min, respectively. Among the 97 children aged 1 year 9 months to 6 years 5 months who received the KIDS questionnaire, 74 (76%) responded, with a median developmental quotient (DQ) of 110. Two children had a DQ below 70, one of whom had trisomy 21. Poor outcomes, including death and DQ below 70, appeared associated with severe congenital diseases or preterm birth.
Conclusions
In this single‐center cohort from a Japanese tertiary perinatal center operating in accordance with national guidelines and established emergency protocols, neonatal and neurodevelopmental outcomes were generally favorable among full‐term infants without severe congenital disease who underwent Category 1 CS. Poor outcomes appeared to be related to fetal conditions including prematurity or anomalies.