C-Sections Might Be Contributing To Increase In Premature Single Births, Study Says

Medically unnecessary caesarean sections might be contributing to an increased rate of premature single births in the U.S., according to a study to be published in the June issue of the journal Clinics in Perinatology, the New York Times reports. The study, conducted by researchers from the March of Dimes Foundation, Albert Einstein College of Medicine of Yeshiva University and CDC, is based on a review of birth records and previous studies. Researchers said the link between c-sections and premature single births is unclear because medical records often do not indicate why the procedure was done.

The study found that premature births increased from 9.7% of all single births in 1996 to 10.7% of single births in 2004. About 92% of the premature single births were delivered by c-section. Most premature births were considered "late preterm" births, defined as delivery between 34 and 37 weeks' gestation, according to the Times. Normal delivery is between 38 and 42 weeks' gestation. Premature infants have higher risks of breathing and feeding disorders, delayed brain development, other health problems and death, the Times reports.

Alan Fleischman, the March of Dimes' medical director and senior vice president, said obstetrics has changed so dramatically during the past 20 years that c-section deliveries and labor inductions have become commonplace. According to the Times, the c-section rate has increased steadily in recent years, from 20.7% of all births in 1996 to 30.3% in 2005. "Perhaps for convenience, perhaps out of fear of litigation, perhaps in response to a maternal request, they are scheduling their deliveries rather than allowing labor to begin," Fleischman said, adding, "And this comes when there is an epidemic in America of prematurity."

Sarah Kilpatrick, chair of the committee on obstetric practice for the American College of Obstetrics and Gynecology and chair of the Department of Obstetrics and Gynecology at the University of Illinois, said there is no proof that unnecessary c-sections are leading in premature births but added that obstetricians might "proceed with a caesarean to deliver the fetus when the fetus is probably fine" out of fear of litigation (Grady, New York Times, 5/28).

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