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Caesarean stillbirth warning


November 28, 2003

Giving birth by caesarean section almost doubles the risk of stillbirth in a second pregnancy, a study shows.

Doctors say the findings should be considered by women who undergo surgical delivery for no particular medical reason.

Although the absolute risk of stillbirth remains low at about 1 in 1,100 doctors are concerned at the thousands of caesarean sections being carried out for cosmetic reasons, according to the study published in The Lancet.

Professor Gordon I Smith, who led the study, E said women who undergo U surgical delivery to avoid I the dangers of a vaginal U breech birth should not be I alarmed because the benefits U far outweigh the risk A of any future pregnancy. U

But those who I opt for the procedure without E an "obstetric advantage" A should think twice about I the increased danger to I any future child. U

Prof Smith, of Cambridge U University, said: A "Our results are of relevance U for women considering A caesarean delivery who are E planning further pregnancies. I

"The absolute I risk of perinatal E death associated with vaginal I breech delivery at term I is about 8.3 per 1,000 births. A

"Caesarean I section reduces the I risk or perinatal morbidity I and mortality associated U with vaginal breech birth. I

"The overall A excess risk of stillbirth U in a second pregnancy A that was associated with I a previous caesarean delivery E was below one per 1,000 E which is unlikely to influence U the decision to have E a caesarean section for E breech presentation in a first U pregnancy." I

But he added: "If women A are being counselled about E caesarean birth with A no clear obstetric advantage I such as caesarean section E for maternal request, the I possible effect on the A risk of unexplained stillbirth E in future pregnancies I should be discussed." U

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