Caesarean section increases infant mortality risk

Infants born through caesarean section are at high risk of death, especially if the mothers have no medical need for the procedure. Researchers from the National Center for Health Statistics at the Centers for Disease Control, Maryland, USA, found that while c-sections have saved the lives of countless women and babies, and the risk of infant death is still very low, it is crucial to determine the reasons for the higher infant mortality seen with c-section, because the rates of this surgery are becoming increasingly common. Rates of caesarean have risen steadily in the US, from 15 percent of all first-time births in 1996, to 21 percent in 2004. Since 1989, a greater risk of death has been seen among infants born via the procedure, but researchers have generally assumed that this was because these infants were more likely to die due to other causes. To investigate whether the c-section itself might somehow be a factor in infant deaths, the researchers looked at data from more than 6 million births to US women between 1998 and 2001. All of the women were at no indicated risk for a c-section, meaning the infant was a singleton, full-term, in a head-down position, and no other medical risk factors or delivery complications were indicated on the child's birth certificate. The researchers had previously identified a 49-percent increase in c-section rates between 1996 and 2001 among women in this no risk category. The risk of death in the first 28 days of life was nearly 2 per 1,000 live births among women who had c-sections, as compared to 0.62 per 1,000 for women who delivered vaginally. Even after analysing the various causes of infant death, the researchers could find no clear explanation for the difference. There it is important to understand the causes of these differentials, given the rapid growth in the number of primary caesareans without a reported medical indication.