A paper published in the Public Library of Science (PLoS) shows that children who were born between 37 – 39 weeks gestation were between 1.43 and 1.16 times more likely to have Special Educational Needs (SEN) compared to babies born at the expected dates (40 – 41 weeks). Interestingly, the study also shows that post-dates babies (born at 42 – 43 weeks) where also found to be more likely to have SEN than those babies born at term (40 – 41 weeks) The authors note that their findings have important implications for the timing of elective deliveries particularly caesarean sections.
Around one third of all caesarean sections are planned. Current clinical practice is for elective caesarean sections to take place at 39 weeks to reduce the risk to the baby but this is before most woman go into labour. The reasons for elective caesarean sections include maternal obesity, multiple pregnancies, breech presentation and birth after a previous caesarean section. There are also medical conditions where caesarean sections are recommended such as pre-eclampsia and gestational diabetes to prevent stillbirth or shoulder dystocia. In some cases, elective caesarean sections are carried out when a mother has a fear of childbirth.
Professor James Walker, spokesperson of the Royal College of Obstetrician and Gynaecologist (RCOG) said, “The findings of the study from Glasgow University do not necessarily mean that c-sections should not be carried out before 40 weeks, as there may be emergency situations requiring immediate action to save mothers’ and babies’ lives. Any medical intervention needs to balance the relative risks.
“What this piece of research shows is that we should try as far as we can to keep elective c-sections as late as possible, where clinically appropriate. Research of this kind will help women and healthcare professionals to be further informed to help in the decisions to be made."
9 June 2010
Notes
Reference
MacKay DF, Smith GCS, Dobbie R, Pell JP (2010) Gestational Age at Delivery and Special Educational Need: Retrospective Cohort Study of 407,503 Schoolchildren. PLoS Med 7(6): e1000289. doi:10.1371/journal.pmed.1000289
To view the NICE Clinical Guideline CG13 Caesarean section (April 2004), click here.
To view NICE patient information on caesarean section (April 2004), click here.