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September 18, 2002

Long-term Pulmonary Consequences of Elective Cesarean Delivery

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;288(11):1352. doi:10.1001/jama.288.11.1350

To the Editor: Dr Smith and colleagues1 concluded that the risk of perinatal death associated with a trial of labor following previous cesarean delivery was significantly higher than that associated with planned repeat cesarean delivery, with an absolute risk increase (ARI) of 0.118% and a number needed to harm (NNH) of 847.

I am concerned that perinatal death was the only neonatal outcome considered. Hook et al2 reported that term neonates who were born by elective repeat cesarean delivery had increased risk of respiratory morbidities compared with those born by trial of labor (ARI, 3%; NNH, 33 for transient tachypnea; ARI, 0.4%; NNH, 250 for respiratory distress syndrome).