Compared with intending to deliver vaginally, choosing to undergo a repeat Cesarean section may raise the risk that the newborn will be admitted to an advanced care nursery, according to a new study. The researchers say women should be alerted to the possible negative effects.

The study, in the May issue of the American Journal of Obstetrics and Gynecology, is the first to directly compare how choosing to undergo a repeat c-section rather than giving labor a try may affect the newborn, note Dr. Nicholas Fogelson and colleagues, from the Medical University of South Carolina in Charleston.

In the study, the investigators assessed the newborn outcomes of 3,134 mothers intending to deliver vaginally and 117 mothers who underwent elective repeat cesarean section.

Babies born to mothers who opted for c-section were nearly four times more likely to be admitted to advanced care nursery than those born to mothers who tried labor first. Rapid breathing, although temporary, was also more common in infants born to mothers choosing c-section.

When the analysis was confined to mothers who underwent c-section after trying labor first, there was no longer a difference between the groups in admission rates to the advanced care nursery.

“The decision to undergo elective cesarean delivery appears to have a negative impact on immediate neonatal outcomes,” the authors state. They advise that for women considering a repeat cesarean delivery, “physicians should counsel patients about potential neonatal issues in addition to concern for maternal well-being.”

SOURCE: American Journal of Obstetrics and Gynecology, May 2005.