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October 28, 1983

Cesarean Section: Risk and Benefits for Mother and Fetus

Author Affiliations

From the Family Planning Evaluation Division, Centers for Disease Control (Drs Sachs, McCarthy, Rubin, and Burton); and the Family Health Services Section, Division of Physical Health, Georgia Department of Human Resources (Dr Terry), Atlanta. Dr Sachs is now with Beth Israel Hospital, Boston. Deceased.

JAMA. 1983;250(16):2157-2159. doi:10.1001/jama.1983.03340160043029

We studied the effects of cesarean section on neonatal mortality for breech infants and low-birth weight vertex infants using data from the Georgia neonatal surveillance network on 392,241 singleton deliveries between 1974 and 1978. The risk of neonatal death for breech infants weighing 4,000 g or less delivered vaginally was significantly higher than the risk for those delivered by cesarean section. The lower the birth weight, the higher the risk for a vaginal breech delivery. For breech infants weighing 1,000 to 2,500 g, the risk was almost 2 1/2 times greater for a vaginal delivery v a cesarean delivery. The best outcome for high-risk vertex infants weighing 1,000 to 1,500 g was for those delivered by cesarean section in a tertiary perinatal center. An increase in the cesarean section rate may be associated with increased neonatal survival; however, the benefits must be weighed against the costs of an increased maternal mortality and morbidity.

(JAMA 1983;250:2157-2159)