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PERSPECTIVE |
1 Department of Obstetrics and Gynaecology, Cambridge University, Cambridge, UK
Correspondence to:
Professor G C S Smith, Department of Obstetrics and Gynaecology, Cambridge University, Rosie Maternity Hospital, Cambridge CB2 2SW, UK; gcss2@cam.ac.uk
| The first 150 words of the full text of this article appear below. |
The caesarean delivery rate continues to increase globally, especially in industrialised nations.1 Any attempt at reducing or reversing this trend has to consider both fetal and maternal risks and benefits of caesarean delivery. This has been the objective of many studies including that by Liston et al in this issue, which examines neonatal morbidity by method of delivery at term in both low- and high-risk women.2 The size of this study allowed the evaluation of rare outcomes (<1%). By confining the analysis to term, morbidity due to preterm birth was excluded, which allows truly delivery-related events to be studied. Caesarean delivery during labour was associated with an up to sixfold risk of depression at birth and up to threefold risk of neonatal respiratory morbidity, in comparison with spontaneous vaginal delivery. The risk of birth trauma was highest after assisted vaginal delivery, followed in decreasing incidence by spontaneous vaginal delivery, caesarean
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