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Risks in Caesarean births

London, Sept.7: Babies are up to three times more likely to die soon after delivery if their mothers choose a Caesarean section rather than a normal birth, a big American study has shown.

The finding will come as a shock to the increasing number of women who opt to have a Caesarean, even if there is no medical need for it.

It has been known for some time that baby deaths are higher after Caesareans than after normal vaginal births, but the reason was always thought to be that many operations were done as emergencies, when problems arose during labour.

The American study is the first to compare death rates after elective surgeries, when women chose the procedure in advance in consultation with their obstetricians. The cases chosen were those of women with no known medical reason for the procedure, or with no special complications during labour.

“Neonatal deaths are rare for low-risk women — of the order of one death per 1,000 live births,” said Marian MacDorman, of the Centres for Disease Control and Prevention in Atlanta, Georgia, who led the study. “But even after we adjusted for socio-economic and medical risk factors, the difference persisted.

“These findings should be of concern for clinicians and policy makers who are observing the rapid growth in the number of primary Caesareans to mothers without a medical indication.”

The team studied more than 5.7 million live births and nearly 12,000 infant deaths in the United States from 1998 to 2001. They counted deaths among babies that occurred within 28 days of birth, called neonatal deaths. They conclude in the journal Birth: Issues in Perinatal Care that the neonatal death rate for Caesarean birth among low-risk women was 1.77 deaths per 1,000 live births. The rate among vaginal births was 0.62.

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